中国临床药理学杂志2017，Vol.33Issue(21)：2110-2113,4.DOI:10.13699/j.cnki.1001-6821.2017.21.006
乌司他丁治疗老年急性重症胰腺炎的临床研究
Clinical trial of ulinastatin in the treatment of elderly patients with acute severe pancreatitis
摘要
Abstract
Objective To evaluate the clinical effect of ulinastatin on serum D-lactic acid (D-LA),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels in elderly patients with acute severe pancreatitis.Methods A total of 120 cases of elderly patients with acute severe pancreatitis were randomly divided into treatment group and control group,60 cases in each group.Control group was given somatostatin injection,the first dose of 250 μg,and then maintained with 250 μg · h-1,omeprazole sodium chloride injection 40 mg + 0.9％ NaCl 100 mL,intravenously guttae,twice a day.The treatment group was given ulinastatin 1.0 × 105 U + 5％ glucose injection 250 mL,intravenous drip on the basis of control group,twice a day.All patients were treated for 1 week.The D-LA,TNF-or,IL-6,amylase and lipase concentration,time of symptom remission,clinical efficacy and safety were compared in two groups.Results After treatment,the effective rates in control and treatment groups were 75.00％ (45 cases/60 cases) and 93.34％ (56 cases/60 cases,P ＜0.05).After treatment,the D-LA levels were (8.16 ± 0.93),(6.24±0.77) μg · L-1 in control group and treatment group.The TNF-α levels were (261.13 ±32.34),(216.32 ± 25.54) pg · mL-1.The C-reactive protein (CRP) were (36.84 ± 5.18),(19.66 ±2.78) mg · L-1.The IL-6 were (74.82 ± 10.21),(52.51 ±7.12) pg · mL-1,with significant difference (P ＜ 0.05).After treatment,the serum amylase in control group and treatment group were (264.41 ± 31.12),(134.64 ± 18.81) U · L-1.The urine amylase were (1864.42 ±233.43),(1019.53 ± 135.42)U · L-1.The lipase were (73.23 ±10.11),(34.43 ± 4.65) U · L-1.The differences in two groups were statistically significant (P ＜0.05).The relief time of abdominal pain in control group and treatment group were (4.63 ± 0.63),(3.18 ± 0.44) d.The relief time of abdominal distension were (5.71 ± 0.76),(4.28 ± 0.61) d.The first defecation time were (32.64 ±4.27),(17.82 ± 2.43) d.The recovery time of bowel sound were (29.56 ± 4.06),(14.39 ± 2.02) d.The differences of those items between the two groups were all statistically significant (P ＜ 0.05).The adverse drug reactions in control group were nausea,rash,and the incidence was 13.33％ (8 cases/60 cases).The adverse drug reactions in treatment group were nausea,rash pain,injection site pain,and the incidence was 8.33％ (5 cases/60 cases).There was no significant difference in adverse drug reactions between the two groups (P ＞0.05).Conclusion Ulinastatin has a prominent therapeutic effect on elderly patients with acute severe pancreatitis.It can protect the intestinal mucosal barrier function,promote the recovery of gastrointestinal function,and significantly reduce the serum D-LA,TNF-α and IL-6 level,with high safety.关键词
急性胰腺炎/乌司他丁/D-乳酸/肿瘤坏死因子-α/白细胞介素-6Key words
acute pancreatitis/ulinastatin/D-lactate/tumor necrosis factor-α/interleukin-6分类
医药卫生引用本文复制引用
徐小彭,李敏雄,黄永鹏,夏惠仪,刘意琼..乌司他丁治疗老年急性重症胰腺炎的临床研究[J].中国临床药理学杂志,2017,33(21):2110-2113,4.基金项目
广东省科技厅医学科研基金资助项目(2014A020221068) （2014A020221068）
