血必净注射液对重症急性胰腺炎患者血清TNF-α、IL-10影响.docVIP

血必净注射液对重症急性胰腺炎患者血清TNF-α、IL-10影响 　 作者：张晓峰 徐华平 赵国海 【摘要】 目的 观察血必净注射液对重症急性胰腺炎(SAP)时血清肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)的影响及其对SAP的治疗作用、机制。方法 将45例SAP患者随机分为治疗组和对照组，治疗组在西医综合治疗基础上加用血必净注射液，对照组仅采用西医综合治疗。检测治疗前及治疗后1、3、6、10d两组患者血清TNF-α、IL-10水平，并评价两组的治疗有效率，白细胞、血淀粉酶恢复时间，腹痛缓解时间，平均住院时间。结果 治疗后治疗组患者白细胞、血淀粉酶恢复正常时间、腹痛缓解时间及平均住院时间均较对照组明显缩短(P＜0.01)。治疗前及治疗后1d，两组患者TNF-α、IL-10水平差异均无统计学意义(P＞0.05)，但在治疗后3、6、10d，治疗组患者血清TNF-α水平较对照组患者显著下降(P＜0.01)，而IL-10水平较对照组患者显著升高(P＜0.01)。结论 血必净注射液能抑制TNF-α分泌，上调IL-1O水平，对SAP具有良好的治疗作用。 【关键词】 重症急性胰腺炎 血清肿瘤坏死因子-α 白细胞介素-10 血必净注射液 【Abstract】 Objective To investigate the effects of Xuebijin injection levels on serum TNF-αand IL-10 in patients with severe acute pancreatitis(SAP)and the mechanisms. Methods 45 patients with SAP were randomly divided into 2 groups. Treating group were treated by routine treatment and Xuebijin injection, control group were routinely treated only．Serum TNF-α and IL-10 were determined before and 1、3、6、10 days after therapy．To evaluate effective rate，recovery time of white blood cell and serum amylase，time of abdominal symptom release and average hospital stay were compared. Result Compared to control group，recovery time of white blood cell and serum amylase， time of abdominal symptom and average hospital stay in treated group were shorter significantly (P＜0.01). No significant changes in serum TNF-α and IL-10 were noticed in the two groups on 1 d(P＞0.05). The serum levels of TNF-α of SAP were significantly decreased in the test group than in the control group on 3 d、6d and 10d after the use of Xuebijing(P＜0.01)．But The serum levels of IL-10 of SAP got significantly higher in the test group than in the control group (P＜0.01)．Conclusion Xuebijin injection has therapeutic effects on SAP by inhabiting serum TNF-α level and increasing IL-10 level. 【Key words】 Severe acute pancreatitis TNF-α IL-10 Xuebijin injection 重症急性胰腺炎(SAP)病程凶险，病死率极高，究其原因，主要是发病机制尚未完全阐明，因而相应的治疗观点一直摇摆不定，始终在探索之中，它也是医学史上争论最多，持续时间最长的一个疾病［１］。近年来的研究显示，SAP早期出现严重的SIRS（全身性炎症反应综合征），随着SIRS的发展势必