【摘要】：目的探討抑制胃酸分泌在重癥急性胰腺炎(SAP)治療中的作用。方法收集2015年10月至2016年10月四川大學(xué)華西醫(yī)院消化內(nèi)科診治的45例SAP患者,將患者隨機(jī)分為常規(guī)治療組(C組,21例)與常規(guī)治療+40mg/d艾司奧美拉唑組(C+E組,24例),療程7d。前瞻性比較1d(基線)、7d血炎癥介質(zhì)[C-反應(yīng)蛋白(CRP)、白介素-6(IL-6)、白介素-8(IL-8)、腫瘤壞死因子-α(TNF-α)及降鈣素原(PCT)],1d(基線)、3d、7d的臨床評(píng)分[急性生理學(xué)與慢性健康狀況評(píng)分系統(tǒng)Ⅱ(APACHEⅡ)、全身炎癥反應(yīng)綜合征評(píng)分(SIRS評(píng)分)、改良Marshall評(píng)分],7d的胃酸水平、大便便血及潰瘍的發(fā)生(胃鏡下)。結(jié)果兩組患者基線數(shù)據(jù)具有可比性;抑酸治療7d,C+E組胃內(nèi)pH值高于C組(5.02±1.61vs.2.83±1.08,P0.001);兩組患者在血炎癥介質(zhì)水平、各項(xiàng)臨床評(píng)分、應(yīng)激潰瘍發(fā)生及大便隱血諸方面差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論抑制胃酸不能改善SAP患者全身炎癥反應(yīng)程度及臨床各項(xiàng)評(píng)分,亦無(wú)益于預(yù)防應(yīng)激性潰瘍及消化道出血。
[Abstract]:Objective to investigate the effect of inhibiting gastric acid secretion in the treatment of severe acute pancreatitis with (SAP). Methods from October 2015 to October 2016, 45 patients with SAP were randomly divided into two groups: routine treatment group (group C, 21 cases) and routine treatment group (C E group, 24 cases). The course of treatment was 7 days. Serum inflammatory mediators [C- reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor- 偽 (TNF- 偽) and procalcitonin (PCT)] were compared prospectively for 1 day (baseline) and 7 days. 1 day (baseline), 3 days and 7 days clinical score [acute physiology and chronic health status scoring system 鈪，

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