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目的:探讨区域动脉灌注乌司他丁与血液净化及其二者联合治疗重症胰腺炎的临床疗效。方法:收集重症胰腺炎患者96例,依据治疗方法不同将其分为A组(实施血液净化治疗,n=30)、B组(实施区域动脉灌注乌司他丁治疗,n=32)、C组(实施区域动脉灌注乌司他丁联合血液净化治疗,n=34),观察治疗前后三组血清白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、肿瘤坏死因子(TNF-α)、T细胞亚群(CD4、CD8、CD4/CD8)、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及药物安全性。结果:治疗后三组IL-10、IL-17、TNF-α、APACHEⅡ评分较治疗前明显降低,CD4、CD8明显升高,而CD4/CD8明显减少,并且治疗后C组各项指标变化最明显,B组次之,而A组最小,三组之间两两相较无统计学差异(P<0.05);治疗后三组药物不良反应发生率相较无统计学差异(P>0.05)。结论:区域动脉灌注乌司他丁与血液净化在治疗重症胰腺炎应用中,联合应用方案在抑制机体炎性因子表达及调节机体免疫功能和改善患者预后效果方面,较单一药物方案更具优势,且有一定安全性。
Objective: To investigate the clinical efficacy of regional arterial infusion of ulinastatin and blood purification and their combined treatment of severe pancreatitis. Methods: Ninety-six patients with severe pancreatitis were divided into group A (n = 30), group B (n = 32) and group C (N = 34). The levels of serum interleukin-10 (IL-10), interleukin-17 (IL-17), tumor necrosis TNF-α, T cell subsets (CD4, CD8, CD4 / CD8), acute physiology and chronic health assessment Ⅱ (APACHEⅡ) score and drug safety. Results: After treatment, the scores of IL-10, IL-17, TNF-α and APACHEⅡ in the three groups were significantly lower than those before treatment, while CD4 and CD8 were significantly increased, while CD4 / CD8 was significantly decreased Obviously, group B was the second, and group A was the smallest with no significant difference between the two groups (P <0.05). There was no significant difference in adverse drug reactions between the three groups after treatment (P> 0.05) . Conclusion: Regional arterial infusion of ulinastatin and blood purification in the treatment of severe pancreatitis application, the combination of programs in inhibiting the expression of inflammatory cytokines and regulate the body’s immune function and improve the prognosis of patients with more advantages than the single drug program, And there is some safety.