本文選題：大黃　切入點：重癥急性胰腺炎　出處：《重慶醫(yī)科大學(xué)學(xué)報》2017年09期 　論文類型：期刊論文

【摘要】：目的:觀察大黃灌腸對重癥急性胰腺炎(severe acute pancreatitis,SAP)患者血清高遷移率族蛋白B1(high mobility group B1,HMGB1)、降鈣素原(procalcitonin,PCT)、白細胞介素-6(interleukin-6,IL-6)、腫瘤壞死因子-α(tumor necrosis factorsα,TNF-α)及疾病預(yù)后的影響。方法:收集SAP患者60例,隨機分為大黃治療觀察組組(大黃灌腸,30例)和常規(guī)治療對照組(肥皂水灌腸,30例),分別在入院后第1、3、5天動態(tài)監(jiān)測各組患者血清的HMGB1、PCT、IL-6與TNF-α濃度變化,并觀察患者腹痛腹脹緩解時間、排氣排便時間、CRRT時間及2組患者的治療效果。結(jié)果:治療當(dāng)天2組患者HMGB1、PCT、IL-6、TNF-α水平差異均無統(tǒng)計學(xué)意義(P值分別為0.535、0.876、0.973、0.419);不同時間點間各組炎癥因子HMGB1、PCT、IL-6、TNF-α的變化存在統(tǒng)計學(xué)差異(P0.01),并且觀察組HMGB1、IL-6、TNF-α的水平較對照組低(P0.01),而PCT表達差異不存在統(tǒng)計學(xué)意義(P=0.059)。Δ3-1HMGB1(第3天與第1天的HMGB1差值)與第3天急性生理與慢性健康(acute physiology and chronic health evaluation system,APACHE)Ⅱ評分呈明顯負相關(guān)(P0.01),而PCT、IL-6、TNF-α與第3天APACHEⅡ評分均無明顯相關(guān)關(guān)系(P值均大于0.05)。治療第5天時,急性胰腺炎嚴(yán)重程度床邊指數(shù)(bedside index for severity in AP,BISAP)觀察組明顯較對照組低(P=0.038)。觀察組的腹痛腹脹時間、排氣排便時間、CRRT時間均較對照組短(P值均小于0.01)。觀察組的總體有效率也明顯高于對照組(P=0.023)。結(jié)論:大黃能夠有效抑制重癥急性胰腺炎患者炎癥因子HMGB1、PCT、IL-6、TNF-α的表達,降低BISAP評分,并且能改善SAP患者的癥狀和轉(zhuǎn)歸,而HMGB1表達量變化可能與患者預(yù)后相關(guān)。
[Abstract]:Objective: to observe the effects of rhubarb enema on the serum high mobility group protein B1C high mobility group B1 HMGB1, procalcitoninine acute, interleukin 6 (IL 6), tumor necrosis factor 偽 necrosis factors 偽 (TNF- 偽) and disease prognosis in severe acute patients with severe acute pancreatitis (SAP). The patients were randomly divided into observation group (30 cases of rhubarb enema) and control group (30 cases of routine treatment group). The serum levels of HMGB1, PCTX, IL-6 and TNF- 偽 were dynamically monitored on 5 days after admission. The remission time of abdominal pain and distension was observed. Results: on the day of treatment, there was no significant difference in the level of HMGB1, PCT1, IL-6, TNF- 偽 between the two groups (P = 0.5350.876n0.973nil 0.419), and the change of HMGB1PCTIL-6TNF- 偽 was statistically significant at different time points. The level of IL-6TNF- 偽 in the observation group was lower than that in the control group, but there was no significant difference in PCT expression between the two groups. 螖 3-1HMGB1 (HMGB1 difference between the 3rd day and the 1st day) and the acute and chronic health evaluation system (Apache che) 鈪，

本文編號：1592711