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为探讨亚胺培南联合谷氨酰胺对重症胰腺炎合并感染患者甲状腺激素及血清降钙素原水平的影响,本研究选取2015年8月至2017年3月期间本院收治的92例重症胰腺炎伴腹部感染患者为本次研究的对象,使用分层随机分组的方式,将研究对象分为对照组以及观察组,两组人数均为46例。均予禁食和胃肠减压,液体复苏等常规治疗方案,对照组加用亚胺培南20 mL/次,静脉滴注,2次/d;研究组在上述基础上加用谷氨酰胺20 g/次,静脉滴注,1次/d。均连续治疗14 d。检测甲状腺相关激素、炎症细胞因子水平变化,并记录症状、体征恢复正常时间,比较临床疗效。结果显示,与治疗前比较,两组促甲状腺激素(TSH)、游离三碘酪氨酸(FT3)、游离四碘酪氨酸(FT4)水平明显升高(p<0.05),反三碘甲状腺原氨酸(rT3)水平明显降低(p<0.05),白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平显著降低(p<0.01);与对照组比较,观察组TSH、FT3、FT4水平明显较高(p<0.05),rT3水平明显较低(p<0.05),WBC计数、PCT、CRP、TNF-α水平显著较低(p<0.01),血、尿淀粉酶恢复时间、肠鸣音恢复时间、排便恢复时间以及住院时间显著较短(p<0.01),总有效率较高(p<0.05)。本研究表明,亚胺培南联合谷氨酰胺治疗重症胰腺炎伴感染疗效确切,可有效改善甲状腺激素、PCT水平,具有显著临床应用价值。
Abstract：In order to investigate the effect of imipenem combined with glutamine on thyroid hormones and serum procalcitonin(PCT) levels in patients with severe acute pancreatitis(SAP) complicated with infection, 92 patients with SAP infection were selected as the research objects, who were divided into control group and observation group according to the stratified random grouping method, with 46 cases in each. All patients were given conventional treatment: fasting and gastrointestinal decompression, fluid resuscitation, etc. The control group was treated with imipenem with 20 mL/time, intravenous drip, 2 times/d. On the basis of the method, the study group was given glutamine with 20 g/time, intravenous drip, 1 time/d, lasting for 14 d. The levels of thyroid related hormones and inflammatory cytokines were detected, and the symptoms and signs returned to normal time were recorded. The clinical efficacy was compared. The results showed that compared with before treatment, the levels of thyroid stimulating hormone(TSH), free three tyrosine(FT3), free four iodine tyrosine(FT4) in the two groups were significantly increased(p<0.05), and the levels of anti three iodine(rT3) were decreased significantly(p<0.05),and the levels of white blood cell count(WBC), procalcitonin(PCT), C reactive protein(CRP) and tumor necrosis factor-α(TNF-α) were significantly decreased(p<0.01). Compared with the control group, the levels of TSH, FT3 and FT4 in the observation group were significantly higher(p<0.05), rT3 significantly lower(p<0.05), PCT, CRP,WBC count, TNF-α significantly lower(p<0.01), and blood and urine amylase recovery time, recovery time of bowel sound, recovery time and defecation hospitalization time were significantly shorter(p<0.01), of which the total efficiency was higher(p<0.05). This study showed that imipenem combined with glutamine was effective in the treatment of SAP complicated with infection, and it could effectively improve the levels of thyroid hormones and PCT, which has significant clinical value.
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基本信息:
DOI：10.13417/j.gab.037.004588
中图分类号:R576
引用信息:
[1]康伟.亚胺培南联合谷氨酰胺对重症胰腺炎合并感染患者甲状腺激素及血清PCT水平的影响[J].基因组学与应用生物学,2018,37(10):4588-4594.DOI:10.13417/j.gab.037.004588.
基金信息:
天津生物工程职业技术学院资助
2018-10-25
2018-10-25