乌司他丁与奥曲肽对重症急性胰腺炎PAF、ICAM-1、免疫功能水平影响及临床治疗效果分析

目的分析乌司他丁与奥曲肽对重症急性胰腺炎血小板活化因子(PAF)、细胞间粘附分子-1(ICAM-1)、免疫功能水平影响及临床治疗效果。方法回顾性选取2012年1月-2017年12月我院收治的重症胰腺炎患者104例,根据治疗方法不同分为对照组和观察组。对照组患者采用奥曲肽治疗,观察组患者采用奥曲肽联合乌司他丁治疗,分析两组患者治疗后的临床效果。结果观察组患者腹痛消失时间、肠鸣音恢复时间和体温、尿淀粉酶、血淀粉酶恢复正常时间均短于对照组(P<0.05)。治疗前,两组患者IgA、IgM、IgG水平比较无统计学差异(P>0.05)。治疗后,观察组患者IgG水平高于对照组,但IgA、IgM水平与对照组比较无统计学差异(P>0.05)。治疗前,两组患者ET、HLA-DR、HSP70、PAF、ICAM-1水平比较无统计学差异(P>0.05)。治疗后,观察组患者HLA-DR水平高于对照组,ET、HSP70、PAF、ICAM-1水平低于对照组(P<0.05)。观察组患者不良反应率为5.77%,对照组为19.23%,观察组患者不良反应率低于对照组(P<0.05)。结论乌司他丁联合奥曲肽治疗重症急性胰腺炎可有效控制患者临床症状,改善患者免疫功能,降低患者血清中ET、PAF、ICAM-1的表达,且不良反应轻,安全性高。

Effect of Ulinastatin and Octreotide on Levels of PAF,ICAM-1,Immune Function and Clinical Efficacy

Objective To analyze the effects of ulinastatin and octreotide on the levels of platelet activating factor(PAF),intercellular adhesion molecule-1(ICAM-1)and clinical efficacy in patients with severe pancreatitis.Methods One hundred and four cases of severe pancreatitis admitted between January 2012 and December 2017 were divided into the control group and the observation group according to the treatment method.The patients in the control group were treated with octreotide,while those in the observation group were treated with octreotide plus ulinastatin.The clinical effects of the two groups were compared.Results The time taken to kill abdominal pain,to resume bowel sound and to restore the normal body temperature,urine amylase and serum amylase was shorter in the observation group than in the control group(P<0.05).Before treatment,the levels of IgA,IgM and IgG showed no significant difference between the two groups(P>0.05).After treatment,the level of IgG in the observation group was higher than that of the control group,but there was no significant difference in the levels of IgA or IgM between the two groups(P>0.05).Before treatment,the levels of ET,HLA-DR,HSP70,PAF and ICAM-1 showed no significant difference between the two groups(P>0.05).After treatment,the levels of HLA-DR and ICAM-1 in the observation group were higher than those in the control group(P<0.05).The adverse reaction rate was 5.77%in the observation group,significantly lower than that in the control group(19.23%)(P<0.05).Conclusion Ulinastatin combined with octretin in the treatment of severe pancreatitis can effectively control the clinical symptoms of patients,improve their immune function,reduce the expressions of serum ET,PAF and ICAM-1,with mild adverse reactions.