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[目的]观察早期肠内营养添加L-谷氨酰胺呱仑酸钠对重症急性胰腺炎(SAP)的临床疗效。[方法]收集2013年3月~2014年8月我院收治的SAP患者74例,分为常规治疗对照组和L-谷氨酰胺呱仑酸钠观察组,每组37例。另取我院体检中心健康体检者40例作为正常对照。ELISA法检测IL-2、IL-6、TNF-α表达。[结果]对照组临床症状消失、血淀粉酶恢复以及住院时间分别为:(5.67±1.32)d、(6.43±1.61)d和(14.92±3.55)d,均显著高于观察组的(3.12±0.56)d、(4.24±1.05)d和(9.47±2.42)d(P<0.05)。治疗前对照组和观察组IL-2、IL-6、TNF-α表达差异无统计学意义(P>0.05),但均显著高于健康对照组(P<0.01)。治疗后观察组对IL-2、IL-6、TNF-α的减低作用显著优于对照组(P<0.01)。观察组的治疗有效率为94.6%显著优于对照组的78.4%(P<0.05)。[结论]L-谷氨酰胺呱仑酸钠可以显著抑制SAP患者的炎症反应,临床疗效显著,值得临床推广使用。
[Objective] To observe the clinical efficacy of early enteral nutrition plus L-glutamine sodium for severe acute pancreatitis (SAP). [Methods] Seventy-four SAP patients admitted from March 2013 to August 2014 in our hospital were divided into routine treatment control group and L-glutamine sodium observation group, 37 cases in each group. Another physical examination in our hospital physical examination of 40 cases as a normal control. ELISA was used to detect the expression of IL-2, IL-6 and TNF-α. [Results] The disappearance of clinical symptoms, blood amylase recovery and hospital stay in the control group were (5.67 ± 1.32) days, (6.43 ± 1.61) days and (14.92 ± 3.55) days, respectively, which were significantly higher than those in the observation group (3.12 ± 0.56) d, (4.24 ± 1.05) d and (9.47 ± 2.42) d, respectively (P <0.05). The levels of IL-2, IL-6 and TNF-α in control group and observation group before treatment were not significantly different (P> 0.05), but were significantly higher than those in healthy control group (P <0.01). After treatment, the reduction effect of IL-2, IL-6 and TNF-α in the observation group was significantly better than that in the control group (P <0.01). The treatment effective rate in the observation group was 94.6%, which was significantly better than 78.4% in the control group (P <0.05). [Conclusion] L-Glutamine sodium can significantly inhibit the inflammatory response in patients with SAP. The clinical efficacy is significant and worthy of clinical promotion.