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目的:探讨乌司他丁用于治疗不同类型急性胰腺炎的临床疗效和安全性。方法:收集2013年1月至2014年1月我院收治的急性胰腺炎患者84例,随机分为观察组与对照组,每组各42例,两组患者均给予常规治疗,对照组加用奥曲肽治疗,观察组在对照组的基础上加用乌司他丁治疗,观察和比较两组患者的临床疗效、治疗前后血清IL-6和TNF-α水平的变化及不良反应的发生情况。结果:观察组的总有效率为96.72%,显著高于对照组的85.71%;其中,两组急性水肿型胰腺炎的疗效相当(P<0.05),但观察组出血坏死型胰腺炎的有效率显著高于对照组(P<0.05)。治疗后,两组血清IL-6与TNF-α水平均较治疗前显著降低,并且观察组显著低于对照组(P<0.05),水肿型胰腺炎患者血清IL-6及TNF-α水平显著低于出血坏死型胰腺炎患者,差异均具有统计学意义(P<0.05)。两组均未发生肝肾功能损害,未见药物相关性不良反应。结论:乌司他丁用于辅助治疗急性胰腺炎能够明显下调炎症因子水平,临床疗效显著,对急性水肿型胰腺炎的疗效尤为显著,安全性好,值得推广应用。
Objective: To investigate the clinical efficacy and safety of ulinastatin in the treatment of different types of acute pancreatitis. Methods: A total of 84 acute pancreatitis patients admitted to our hospital from January 2013 to January 2014 were randomly divided into observation group and control group, with 42 cases in each group. Both groups were given routine treatment and control group Octreotide treatment. The observation group was treated with ulinastatin on the basis of the control group. The clinical curative effect, the change of serum IL-6 and TNF-α level before and after treatment and the incidence of adverse reactions were observed and compared. Results: The total effective rate in the observation group was 96.72%, which was significantly higher than that in the control group (85.71%). The efficacy of acute edematous pancreatitis was similar in both groups (P <0.05). However, the effective rate of hemorrhagic necrotizing pancreatitis Significantly higher than the control group (P <0.05). After treatment, the serum levels of IL-6 and TNF-α in both groups were significantly lower than those before treatment, and the levels in the observation group were significantly lower than those in the control group (P <0.05). The levels of serum IL-6 and TNF-α in the patients with edematous pancreatitis were significantly Lower than hemorrhagic necrotizing pancreatitis patients, the difference was statistically significant (P <0.05). Liver and kidney dysfunction did not occur in both groups, and no drug-related adverse reactions were found. CONCLUSION: Ulinastatin can be used to assist in the treatment of acute pancreatitis and significantly reduce the level of inflammatory cytokines. The clinical effect is significant, and the curative effect on acute edematous pancreatitis is particularly remarkable. It is safe and worthy to be popularized and applied.