标题：乌司他丁治疗急性胰腺炎对患者免疫功能及炎症介质水平的影响

      作者：孙洋，张波，武琼    榆林市第二医院消化内科，陕西 榆林 719000

      卷次： 2023年34卷24期

      【摘要】 目的 探讨乌司他丁治疗急性胰腺炎对患者免疫功能及炎症介质水平的影响。方法 选取2020年1月至2022年1月榆林市第二医院收治的124例急性胰腺炎患者作为研究对象，依据随机数表法分为对照组与观察组各 62例。对照组患者采用奥曲肽治疗，观察组患者在对照组治疗的基础上联合乌司他丁治疗，均治疗10 d。比较两组患者治疗后的各项临床指标、治疗前后的免疫功能[血清免疫球蛋白A (IgA)、免疫球蛋白M (IgM)、免疫球蛋白G (IgG)]和炎症介质[C反应蛋白(CRP)、白介素-6 (IL-6)、白介素-8 (IL-8)、白介素-10 (IL-10)]水平，以及治疗期间的不良反应发生情况。结果 观察组患者的腹痛缓解时间、体温恢复正常时间、住院时间、尿淀粉酶恢复正常时间以及血淀粉酶恢复正常时间明显短于对照组，差异均具有统计学意义(P<0.05)；治疗后，两组患者的IgA、IgM、IgG均高于治疗前，且观察组分别为(5.29±0.59) g/L、(1.98±0.21) g/L、(20.15±2.21) g/L，明高于对照组的(4.55±0.65) g/L、(1.33±0.17) g/L、(16.28±2.14) g/L，差异均有统计学意义(P<0.05)；治疗后，两组患者的血清 IL-10水平明显高于治疗前，且观察组为(105.28±10.02) pg/mL，明显高于对照组的(95.35±10.23) pg/mL，治疗后两组患者的血清CRP、IL-6、IL-8水平明显低于治疗前，且观察组分别为(40.19±8.19) mg/L、(30.47±10.17) pg/mL、(60.36±15.35) pg/mL，明显低于对照组的(59.21±8.81) mg/L、(60.26±10.25) pg/mL、(95.27±16.28) pg/mL，差异均具有统计学意义(P<0.05)；观察组患者治疗期间的总不良反应发生率为 8.06%，明显低于对照组的 22.58%，差异有统计学意义(P<0.05)。结论 乌司他丁联合奥曲肽治疗可以提高急性胰腺炎患者的免疫功能，改善淀粉酶水平，减轻机体炎症反应，有利于疾病的快速恢复，且药物安全性更高。
      【关键词】 急性胰腺炎；奥曲肽；乌司他丁；免疫功能；炎症介质
      【中图分类号】 R576 【文献标识码】 A 【文章编号】 1003—6350（2023）24—3540—04

Effects of ulinastatin on immune function and levels of inflammatory mediators in patients with acutepancreatitis.
SUN Yang, ZHANG Bo, WU Qiong. Department of Gastroenterology, Yulin Second Hospital, Yulin 719000,Shaanxi, CHINA
【Abstract】 Objective To investigate the effects of ulinastatin on immune function and levels of inflammatorymediators in patients with acute pancreatitis. Methods A total of 124 patients with acute pancreatitis in Yulin SecondHospital from January 2020 to January 2022 were selected and divided into the control group and the observation groupaccording to the random number table method, with 62 cases in each group. Patients in the control group were treatedwith octreotide, and those in the observation group were treated with ulinastatin on the basis of the treatment in the con-trol group. Both groups of patients were treated for 10 d. The clinical indexes after treatment, serum immunoglobulin A(IgA), immunoglobulin M (IgM), immunoglobulin G (IgG), C-reactive protein (CRP), interleukin-6 (IL-6), interleu-kin-8 (IL-8), and interleukin-10 (IL-10) levels before and after treatment, the occurrence of adverse reactions duringtreatment were compared between the two groups. Results The time of relieving abdominal pain, time of recoveringbody temperature, length of hospital stay, time of recovering urine amylase, and time of recovering blood amylase in theobservation group were significantly shorter than those of the control group (P<0.05). After treatment, the levels of IgA,IgM, and IgG of the two groups were significantly higher than those before treatment, and the levels in the observationgroup were (5.29±0.59) g/L, (1.98±0.21) g/L, (20.15±2.21) g/L, significantly higher than (4.55±0.65) g/L, (1.33±0.17) g/L,(16.28±2.14) g/L in the control group (P<0.05). After treatment, the levels of serum IL-10 of the two groups were signifi-cantly higher than those before treatment, and the level in the observation group was significantly higher than that in thecontrol group [(105.28±10.02) pg/mL vs (95.35±10.23) pg/mL], with statistically significant differences (P<0.05). Aftertreatment, the levels of serum CRP, IL-6, and IL-8 of the two groups were significantly lower than those before treat-ment, and the levels in the observation group [(40.19±8.19) mg/L, (30.47±10.17) pg/mL, (60.36±15.35) pg/mL] were sig-nificantly lower than those in the control group [(59.21±8.81) mg/L, (60.26±10.25) pg/mL, (95.27±16.28) pg/mL], withstatistically significant differences (P<0.05). The total incidence of adverse reactions in the observation group was8.06%, which was significantly lower than 22.58% of the control group (P<0.05). Conclusion Ulinastatin can improvethe immune function of patients with acute pancreatitis, improve the level of amylase, reduce the inflammatory reaction,and is conducive to the rapid recovery of the disease, with higher safety.
      【Key words】 Acute pancreatitis; Octreotide; Ulinastatin; Immune function; Inflammatory mediators