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目的:探讨丙氨酰谷氨酰胺(Ala-Gln)联合奥曲肽治疗重症急性胰腺炎(SAP)的临床疗效及对患者血清白细胞介素-6(IL-6)、C反应蛋白(CRP)水平及相关生化指标的影响。方法:选取我院2013年1月~2016年12月收治的100例SAP患者,根据随机数字表法均分为两组。对照组仅予以奥曲肽治疗,观察组给予Ala-Gln联合奥曲肽治疗。记录比较两组的临床疗效、治疗前后血清IL-6、CRP、淀粉酶(AMY)、乳酸脱氢酶(LDH)、前清蛋白(PA)和白蛋白(ALB)水平的变化情况。结果:治疗10 d后,观察组总有效率为88.0%,明显高于对照组的64.0%(P<0.05)。两组治疗10 d后血清IL-6、CRP、AMY、LDH水平均显著低于治疗前(P<0.01),且与对照组对比,观察组血清IL-6、CRP、AMY、LDH水平的改善程度均更为显著(P<0.01)。与治疗前相比,两组治疗10 d后血清PA、ALB水平均明显上升(P<0.05),且观察组治疗10 d后血清PA和ALB水平的改善程度均显著优于对照组(P<0.01)。结论:丙氨酰谷氨酰胺联合奥曲肽治疗更能有效消除或缓解重症急性胰腺炎患者的症状与体征,控制机体炎症反应,提高营养代谢水平,改善预后。
Objective: To investigate the clinical efficacy of Ala-Gln combined with octreotide in the treatment of severe acute pancreatitis (SAP) and its effect on serum interleukin-6 (IL-6) and C-reactive protein (CRP) The impact of relevant biochemical indicators. Methods: A total of 100 patients with SAP who were admitted to our hospital from January 2013 to December 2016 were randomly divided into two groups according to the random number table. The control group was treated with octreotide only. The observation group was given Ala-Gln combined with octreotide. The changes of serum IL-6, CRP, amylase (AMY), lactate dehydrogenase (LDH), pre-albumin (PA) and albumin (ALB) were compared between the two groups. Results: After 10 days of treatment, the total effective rate in observation group was 88.0%, which was significantly higher than that in control group (64.0%, P <0.05). The levels of IL-6, CRP, AMY and LDH in the two groups after treatment for 10 d were significantly lower than those before treatment (P <0.01), and compared with the control group, the levels of IL-6, CRP, AMY and LDH The degree was more significant (P <0.01). Compared with those before treatment, serum PA and ALB levels were significantly increased (P <0.05) after 10 days of treatment in both groups, and PA and ALB levels in the observation group ten days after treatment were significantly better than the control group (P < 0.01). Conclusion: Alanyl glutamine combined with octreotide treatment can effectively eliminate or relieve the symptoms and signs of patients with severe acute pancreatitis, control the body inflammatory response, increase the level of nutrition and metabolism, and improve the prognosis.