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目的:研究低分子肝素和乌司他丁单用及联合治疗急性胰腺炎的疗效。方法:135例急性胰腺炎患者随机平均分为A、B、C三组,均行常规治疗,A组加服低分子肝素,B组加服乌司他丁,C组联合应用两药,对比三组症状治愈时间、转归、肠道黏膜屏障功能和炎症因子变化。结果:C组腹痛、呕吐、进食、体温、白细胞和血尿淀粉酶改善时间显著高于A、B两组,B组腹痛、呕吐、体温和血尿淀粉酶改善显著高于A组;A组缓解率80%,重症化13.33%,手术6.67%,B组分别为82.22%、11.11%和6.67%,C组分别为95.56%、2.22%和2.22%,C组缓解率显著高于A、B两组;治疗后三组DAO、D-乳酸和尿L/M值显著降低,且降低幅度由高至低依次为C、B和A组;治疗后三组TNF-α和IL-1含量显著降低,IL-10含量显著升高,C组降低或升高幅度显著高于A、B两组,A、B两组TNF-α、IL-1差异显著。结论:低分子肝素联合乌司他丁治疗急性胰腺炎疗效较单用两药效果显著,可显著改善患者肠道黏膜屏障功能,降低炎症反应,值得临床推广。
Objective: To study the curative effect of low molecular weight heparin and ulinastatin alone and in combination on acute pancreatitis. Methods: A total of 135 patients with acute pancreatitis were randomly divided into three groups: A, B and C, and received routine treatment. A group received low molecular weight heparin, B group plus ulinastatin, and C group combined with two drugs. Three groups of symptoms healing time, outcome, intestinal mucosal barrier function and inflammatory cytokines. Results: The improvement time of abdominal pain, vomiting, feeding, body temperature, white blood cells and hematuria in group C were significantly higher than those in groups A and B. The improvement of abdominal pain, vomiting, body temperature and hematuria in group B were significantly higher than those in group A; 80%, 13.33% of severe diseases and 6.67% of surgery, the rates of 82.22%, 11.11% and 6.67% in group B and 95.56%, 2.22% and 2.22% in group C, respectively ; After treatment, the L / M values of DAO, D-lactate and urine in three groups were significantly decreased, and the decreasing ranges from high to low were C, B and A; the levels of TNF-α and IL- IL-10 content was significantly increased, C group decreased or increased amplitude was significantly higher than A, B two groups, A, B two groups significant difference in TNF-α, IL-1. Conclusion: The therapeutic effect of low molecular weight heparin combined with ulinastatin on acute pancreatitis is significantly better than that of single drug and two drugs, which can significantly improve the intestinal mucosal barrier function and reduce the inflammatory reaction, which is worthy of clinical promotion.