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目的探讨生长抑素联合质子泵抑制剂治疗重症胰腺炎(SAP)患者的疗效及对其二胺氧化酶、D-乳糖水平变化的影响。方法选取2014年5月—2016年4月中国人民解放军第152中心医院64例SAP患者,通过随机数字表法分组,各32例。对照组采用常规治疗,研究组在常规治疗基础上给予生长抑素联合质子泵抑制剂治疗,两组均持续治疗7 d。统计对比两组临床疗效、不良反应发生率,分析入院时及疗程结束后两组D-乳糖与二胺氧化酶水平变化情况。结果研究组治疗有效率90.62%(29/32)高于对照组68.75%(22/32),差异有统计学意义(P<0.05);治疗前两组腹内高压、D-乳糖与二胺氧化酶水平比较,差异无统计学意义(P>0.05),治疗后两组各指标水平均较治疗前降低,且研究组腹内高压、D-乳糖与二胺氧化酶水平低于对照组,差异有统计学意义(P<0.05);治疗前两组IL-8及TNF-α水平比较,差异无统计学意义(P>0.05),治疗后两组各指标水平均较治疗前降低,且研究组IL-8及TNF-α水平低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率15.64%(5/32)与对照组21.88%(7/32)比较,差异无统计学意义(P>0.05)。结论重症胰腺炎患者联合采用生长抑素及质子泵抑制剂疗效显著,可减少临床症状缓解时间,降低二胺氧化酶、D-乳糖、腹内高压、血清炎症因子水平,且安全性较高,值得推广。
Objective To investigate the effect of somatostatin combined with proton pump inhibitor in the treatment of severe pancreatitis (SAP) and its effect on the changes of diamine oxidase and D-lactose. Methods Sixty-four patients with SAP in the 152nd Central Hospital of People’s Liberation Army from May 2014 to April 2016 were selected and divided into two groups according to a random number table. The control group received routine treatment. The study group was treated with somatostatin and proton pump inhibitor on the basis of routine treatment. Both groups were treated for 7 days. The clinical efficacy and incidence of adverse reactions were compared between the two groups. The changes of D-lactose and diamine oxidase levels after admission and at the end of treatment were analyzed. Results The effective rate of treatment in study group was 90.62% (29/32), which was significantly higher than that in control group (68.75%, 22/32) (P <0.05) (P> 0.05). After treatment, the levels of each index in both groups were lower than those before treatment, and the intra-abdominal high pressure, D-lactose and diamine oxidase levels in the study group were lower than those in the control group, (P <0.05). There was no significant difference in the levels of IL-8 and TNF-α between the two groups before treatment (P> 0.05). After treatment, the levels of IL-8 and TNF- The levels of IL-8 and TNF-α in the study group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the study group was 15.64% (5/32) compared with 21.88% (7/32) in the control group , The difference was not statistically significant (P> 0.05). Conclusions The combination of somatostatin and proton pump inhibitor in patients with severe acute pancreatitis has significant curative effect, which can reduce the time of clinical symptom relief, reduce the levels of diamine oxidase, D-lactose, intra-abdominal hypertension and serum inflammatory cytokines and have higher safety, Worth promoting.