低分子量肝素干预治疗重症急性胰腺炎及对TNF-α的影响(1)
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[摘要]目的 探讨低分子量肝素(low molecular weight heparin，LMWH)干预治疗重症急性胰腺炎( severe acute pancreatitis， SAP)患者的疗效以及对患者外周血TNF-α的影响。方法 将收治的40例SAP患者随即分为对照组和治疗组，对照组采用常规治疗方案，治疗组在常规治疗的基础上加用LMWH 100mg/kg，皮下注射，1次/12h，连续2周。比较两组患者的APACHE-II评分、治愈率、病死率、并发症以及外周血TNF-α水平。结果 与对照组相比，治疗组治愈率明显提高(P<0.05)，病死率明显下降(P<0.05)，并发症明显减少(P<0.05)，APACHE-II评分下降(P<0.05)，TNF-α水平明显下降(P<0.05)。结论 LMWH通过减少炎症因子TNF-α，改善微循环障碍，缓解临床症状，缩短病程。
[关键词] 低分子量肝素；急性胰腺炎；TNF-α；炎症因子
[中图分类号] R576 [文献标识码] B [文章编号] 1673-9701(2011)26- 49-02
Low Molecular Weight Heparin Protects Severe Acute Pancreatitis Patients Via Lowering Tumor Necrosis Factor-α
ZHANG Haiding1 YE Jihui2
1.Department of Internal Medicine，Fenghua Xikou Hospital，Fenghua 315502，China；2.ICU of the First Hospital of Ningbo City，Ningbo 315010， China
[Abstract] Objective To explore the therapeutic effects of low molecular weight heparin on severe acute pancreatitis(SAP). Methods All 40 cases of SAP randomLy divided into 2 groups. Control group(n=20) received conventional treatment. The treatment group(n=20) received low molecular weight(LMWH，100mg/kg，once/12h，2 weeks) except conventional treatment. There was no significant difference between control group and the treatment group in ordinary conditions(P>0.05). Results 16(80.0%)out of 20 cases were cured and 4(20.0%) died in treatment group； 13(65.0 %) out of 20 cases were cured and 7(35.0%) died in control group. The therapeutic efficacy of treatment group was superior to control group，there was significant difference between two groups(P<0.05). The APACHE-II point in treatment group at the fourteenth day(0.09±.0.05) were significantly lower than the control group(0.19±.0.08)(P<0.05). Conclusion Low molecular weight heparin protects severe acute pancreatitis patients via lowering tumor necrosis factor-α levels.
[Key words] Low molecular weight；Severe acute pancreatitis；Tumor necrosis factor-α； Inflammatory factor
重症急性胰腺炎 (severe acute pancreatitis，SAP)是危重的急腹症，病死率可高达20%～30%[1]。除胰酶、内毒素在胰腺炎的发病中起重要作用外，一些炎症介质如肿瘤坏死因子-α (TNF-α)也参与了发病的全过程 ......
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