【摘要】 目的探讨生长激素释放抑制激素(SS)联合重组人生长激素(rh GH)治疗重症急性胰腺炎(SAP)的效果。方法对2013年7月—2015年7月收治的SAP 51例的临床资料进行回顾性分析,根据治疗方案分为观察组30例和对照组21例。对照组给予SS微量泵静脉注射,24 h维持;观察组于应用SS第4天注射rh GH。观察两组恢复情况、中转手术率、严重并发症发生率及病死率,并记录不良反应发生情况,检测两组炎性细胞水平、T淋巴细胞水平及肠黏膜屏障功能指标。结果观察组腹痛消失时间、住ICU时间、住院时间均短于对照组(P<0.05)。两组治疗后肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、白介素-6(IL-6)、高迁移率蛋白-1(HMGB-1)、二胺氧化酶、D-乳酸水平均低于治疗前,且观察组低于对照组(P<0.05)。两组治疗后CD4+、CD4+/CD8+高于治疗前,且观察组高于对照组(P<0.05)。观察组中转手术率、严重并发症发生率和病死率低于对照组(P<0.05)。观察组1例死于多器官功能衰竭,对照组死于多器官功能衰竭和呼吸衰竭各1例。两组均未发生严重不良反应。结论 SS联合rh GH治疗SAP能够减轻炎症水平,提高机体免疫力,降低中转手术率和严重并发症发生率。更多还原

【Abstract】 Objective To investigate effect of recombinant human growth hormone( rh GH) combined with somatostatin( SS) in treatment of patients with severe acute pancreatitis( SAP). Methods Clinical data of 51 SAP patients admitted during July 2013 and July 2015 was analyzed retrospectively,and the patients were divided into observation group( n = 30) and control group( n = 21) according to therapic methods. Control group was injected with growth hormone releasing inhibiting hormone intravenously by micro pump for 24 h maintenance,while observation group was injected with rh GH on the 4thd of medication of growth hormone releasing inhibiting hormone. Recovery condition,operative conversion rate,incidence rate of severe complications and fatality rate were observed,and condition of adverse reaction was recorded,and levels of inflammatory cells and T lymphocytes and intestinal mucosal barrier function indexes were also detected in the two groups. Results Extinction time of abdominal pain,length of ICU stay and hospitalization time in observation group were shorter than those in control group( P < 0. 05). After treatment,levels of tumor necrosis factor alpha( TNF-α),interleukin-1( IL-1),interleukin-6( IL-6),high mobility group protein box-1( HMGB-1),diamine oxidase and D-lactate in observation group were significantly lower than those before treatment in two groups,and the levels in observation group were lower than those in control group( P < 0. 05). After treatment,CD4 + and CD4 + / CD8 + values were significantly higher than those before treatment in two groups,and the values in observation group were significantly higher than those in control group( P < 0. 05). Operative conversion rate,incidence rate of severe complications and fatality rate in observation group were significantly lower than those in control group( P < 0. 05). In observation group,1 patient died of multiple organ failure,and in control group 1 patient died of multiple organ failure and 1 died of respiratory failure. No severe adverse reaction was found in two groups. Conclusion SS combined with rh GH in treatment of SAP patients can reduce inflammation level,improve the body’s immunity and reduce operative conversion and incidence rates of severe complications.更多还原