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目的:探究连续性血液净化联合乌司他丁对急性胰腺炎患者TLR4、白介素及血浆炎症因子的影响。方法:选择2014年1月至2016年1月我院接诊的72例急性胰腺炎患者,并采用随机的方法分为实验组与对照组各36例。实验组与对照组均进行基础治疗和乌司他丁治疗,而实验组还要进行连续性血液净化治疗。记录治疗后APACHEⅡ评分、住院时间、腹痛消失时间、血清淀粉酶恢复时间,测量患者治疗前和治疗一周后的TLR4、血浆炎症因子及白介素水平。结果:(1)实验组患者治疗后住院时间、血清淀粉酶恢复时间、APACHEⅡ评分、腹痛消失时间均显著低于或少于对照组患者(P<0.05)。(2)相较于治疗前,两组患者治疗一周后的TLR4、CRP、IL-6和TNF-α水平均显著降低(p<0.05);实验组患者治疗一周后的TLR4、CRP、IL-6和TNF-α的水平均显著低于对照组(p<0.05)。(3)实验组的治愈率(34.29%)和总有效率(74.29%)均显著高于对照组的治愈率(14.29%)和总有效率(48.57%)。结论:连续性血液净化治疗联合乌司他丁对急性胰腺炎患者的抗炎效果相较于单独使用乌司他丁疗效显著,能更好地降低炎症反应,使得TLR4、血浆炎症因子及白介素等炎症因子降低。
Objective: To investigate the effects of continuous blood purification combined with ulinastatin on TLR4, interleukin and plasma inflammatory factors in patients with acute pancreatitis. Methods: A total of 72 patients with acute pancreatitis admitted to our hospital from January 2014 to January 2016 were selected and randomly divided into experimental group and control group with 36 cases each. The experimental group and the control group were treated with basic and ulinastatin, while the experimental group should be treated with continuous blood purification. APACHE II score, length of hospital stay, disappearance of abdominal pain and serum amylase recovery time were recorded. TLR4, plasma inflammatory factors and interleukin levels were measured before and after treatment. Results: (1) The hospital stay, serum amylase recovery time, APACHE II score and disappearance of abdominal pain were significantly lower in the experimental group than those in the control group (P <0.05). (2) The levels of TLR4, CRP, IL-6 and TNF-α in the two groups were significantly decreased after treatment for one week (p <0.05) compared with those before treatment; TLR4, CRP and IL- 6 and TNF-α levels were significantly lower than the control group (p <0.05). (3) The cure rate (34.29%) and total effective rate (74.29%) of the experimental group were significantly higher than the control group (14.29%) and the total effective rate (48.57%). Conclusion: Continuous blood purification combined with ulinastatin anti-inflammatory effects in patients with acute pancreatitis compared with the single use of ulinastatin significant effect, can better reduce the inflammatory response, making TLR4, plasma inflammatory cytokines and interleukin Inflammatory factors are reduced.