胃肠病学
胃腸病學
위장병학
CHINESE JOURNAL OF GASTROENTEROLOGY
2014年
11期
678-681
,共4页
陈国胜%薛绮萍%许海尘%徐伟%邵耘%孙为豪
陳國勝%薛綺萍%許海塵%徐偉%邵耘%孫為豪
진국성%설기평%허해진%서위%소운%손위호
急性胰腺炎%血小板%乌司他丁%老年人%回顾性研究
急性胰腺炎%血小闆%烏司他丁%老年人%迴顧性研究
급성이선염%혈소판%오사타정%노년인%회고성연구
AcutePancreatitis%BIoodPIateIets%UIinastatin%Aged%RetrospectiveStudies
背景：急性胰腺炎（ AP）发病过程中常伴有胰腺微循环障碍、凝血和纤溶系统改变，血小板参数会发生一定的变化。目的：探讨老年AP患者血小板参数的变化特点以及乌司他丁（ UTI ）治疗对血小板参数和病情的影响。方法：回顾性收集南京医科大学第一附属医院2009年8月至2013年12月收治的年龄≥60岁的AP患者217例，根据病情严重程度分为轻、中、重度AP（ MAP、MSAP和SAP）。比较、分析各组治疗前后的血小板参数（ PLT、MPV和PDW）以及常规治疗与UTI治疗组间血小板参数和临床疗效的差异。结果：与MAP组相比，MSAP、SAP组入院时PLT较低（P＜0.01），MPV、PDW较高（P＜0.05）；治疗1周后，MSAP、SAP组PLT显著增高（P＜0.01），MPV、PDW显著降低（P＜0.05）。与常规治疗相比，MSAP、SAP组UTI治疗后PLT显著增高（P＜0.01），MPV、PDW显著降低（P＜0.01），总有效率显著提高（MSAP：92.3%对81.2%，P＜0.01；SAP：90.0%对80.8%，P＜0.01）。结论：老年MSAP、SAP患者的血小板参数变化与MAP患者明显不同，可反映其病情严重程度。UTI可有效降低血小板活性，对老年AP患者有较好的治疗和预防病情恶化作用。
揹景：急性胰腺炎（ AP）髮病過程中常伴有胰腺微循環障礙、凝血和纖溶繫統改變，血小闆參數會髮生一定的變化。目的：探討老年AP患者血小闆參數的變化特點以及烏司他丁（ UTI ）治療對血小闆參數和病情的影響。方法：迴顧性收集南京醫科大學第一附屬醫院2009年8月至2013年12月收治的年齡≥60歲的AP患者217例，根據病情嚴重程度分為輕、中、重度AP（ MAP、MSAP和SAP）。比較、分析各組治療前後的血小闆參數（ PLT、MPV和PDW）以及常規治療與UTI治療組間血小闆參數和臨床療效的差異。結果：與MAP組相比，MSAP、SAP組入院時PLT較低（P＜0.01），MPV、PDW較高（P＜0.05）；治療1週後，MSAP、SAP組PLT顯著增高（P＜0.01），MPV、PDW顯著降低（P＜0.05）。與常規治療相比，MSAP、SAP組UTI治療後PLT顯著增高（P＜0.01），MPV、PDW顯著降低（P＜0.01），總有效率顯著提高（MSAP：92.3%對81.2%，P＜0.01；SAP：90.0%對80.8%，P＜0.01）。結論：老年MSAP、SAP患者的血小闆參數變化與MAP患者明顯不同，可反映其病情嚴重程度。UTI可有效降低血小闆活性，對老年AP患者有較好的治療和預防病情噁化作用。
배경：급성이선염（ AP）발병과정중상반유이선미순배장애、응혈화섬용계통개변，혈소판삼수회발생일정적변화。목적：탐토노년AP환자혈소판삼수적변화특점이급오사타정（ UTI ）치료대혈소판삼수화병정적영향。방법：회고성수집남경의과대학제일부속의원2009년8월지2013년12월수치적년령≥60세적AP환자217례，근거병정엄중정도분위경、중、중도AP（ MAP、MSAP화SAP）。비교、분석각조치료전후적혈소판삼수（ PLT、MPV화PDW）이급상규치료여UTI치료조간혈소판삼수화림상료효적차이。결과：여MAP조상비，MSAP、SAP조입원시PLT교저（P＜0.01），MPV、PDW교고（P＜0.05）；치료1주후，MSAP、SAP조PLT현저증고（P＜0.01），MPV、PDW현저강저（P＜0.05）。여상규치료상비，MSAP、SAP조UTI치료후PLT현저증고（P＜0.01），MPV、PDW현저강저（P＜0.01），총유효솔현저제고（MSAP：92.3%대81.2%，P＜0.01；SAP：90.0%대80.8%，P＜0.01）。결론：노년MSAP、SAP환자적혈소판삼수변화여MAP환자명현불동，가반영기병정엄중정도。UTI가유효강저혈소판활성，대노년AP환자유교호적치료화예방병정악화작용。
BacKground:The deveIopment of acute pancreatitis( AP ) is often accompanied by pancreatic microcircuIation disturbance and aIterations in bIood coaguIation and fibrinoIytic systems, which resuIts in abnormaIities of pIateIet parameters. Aims:To investigate the changes of pIateIet parameters in eIderIy AP patients and the effect of uIinastatin ( UTI)on pIateIet parameters and disease status. Methods:Two hundred and seventeen eIderIy AP patients(≥60 years) were enroIIed retrospectiveIy from Aug. 2009 to Dec. 2013 at the First AffiIiated HospitaI of Nanjing MedicaI University. According to the severity of the disease,patients were divided into three groups:miId AP( MAP),moderateIy severe AP ( MSAP),and severe AP( SAP). The pIateIet parameters,incIuding PLT,MPV and PDW before and after treatment,as weII as the differences in pIateIet parameters and cIinicaI efficacy between conventionaI therapy and UTI therapy were compared and anaIyzed. Results:In MSAP and SAP groups,PLT at admission was significantIy Iower(P<0. 01),whiIe MPV and PDW were significantIy higher(P<0. 05)than those in MAP group. After 1-week treatment,PLT increased significantIy(P<0. 01)and MPV and PDW decreased significantIy(P<0. 05)in MSAP and SAP groups. UTI therapy was superior to conventionaI therapy in increasing PLT( P <0. 01 ),decreasing MPV and PDW( P <0. 01 ),and improving the overaII efficacy in MSAP and SAP groups( MSAP:92. 3% vs. 81. 2%,P <0. 01;SAP:90. 0% vs. 80. 8%,P<0. 01). Conclusions:Changes of pIateIet parameters in eIderIy MSAP and SAP patients are different from those in MAP patients,which might refIect the disease severity. UTI is effective in reducing the activity of pIateIet and can be used in the treatment and prevention of disease progression in eIderIy AP patients.
