CAJ | 학술논문

目的：探讨硫酸镁对急性结石性胆囊炎患者C－反应蛋白（ C－reactive protein，CRP）、血清胆红素、白细胞、中性粒细胞及胃肠功能的影响。方法急性结石性胆囊炎患者117例随机分为观察组（ n＝60）和对照组（ n＝57）。对照组应用常规治疗，观察组在此基础上结合硫酸镁治疗。分析2组患者白细胞计数与中性粒细胞比值、血清 CRP 与总胆红素水平、血浆血管活性肠肽（ vasoactive intestinal peptide，VIP）与胃动素（ motilin，MTL）水平及发热、腹痛及胆囊肿大消失时间。结果治疗后，观察组患者白细胞计数与中性粒细胞比值显著低于治疗前（ P＜0．05），对照组上述指标与治疗前比较无明显变化；治疗后，观察组患者白细胞计数与中性粒细胞比值显著低于对照组（P＜0．05）。治疗后，观察组患者血清CRP和总胆红素水平显著低于治疗前（P＜0．05），对照组患者血清CRP显著低于治疗前（ P＜0．05），而总胆红素与治疗前比较无明显变化；治疗后，观察组患者血清CRP和总胆红素水平显著低于对照组（P＜0．05）。治疗后，2组患者VIP低于治疗前（P＜0．05），MTL水平高于治疗前（P＜0．05）；治疗后，观察组VIP低于对照组（P＜0．05），MTL水平高于对照组（P＜0．05）。治疗后，观察组发热、腹痛、胆囊肿大消失时间均短于对照组（P＜0．05）。结论硫酸镁其作用机制可能与降低患者白细胞计数、中性粒细胞比值、血清CRP和总胆红素水平、VIP水平及提高MTL水平相关。
목적：탐토류산미대급성결석성담낭염환자C－반응단백（ C－reactive protein，CRP）、혈청담홍소、백세포、중성립세포급위장공능적영향。방법급성결석성담낭염환자117례수궤분위관찰조（ n＝60）화대조조（ n＝57）。대조조응용상규치료，관찰조재차기출상결합류산미치료。분석2조환자백세포계수여중성립세포비치、혈청 CRP 여총담홍소수평、혈장혈관활성장태（ vasoactive intestinal peptide，VIP）여위동소（ motilin，MTL）수평급발열、복통급담낭종대소실시간。결과치료후，관찰조환자백세포계수여중성립세포비치현저저우치료전（ P＜0．05），대조조상술지표여치료전비교무명현변화；치료후，관찰조환자백세포계수여중성립세포비치현저저우대조조（P＜0．05）。치료후，관찰조환자혈청CRP화총담홍소수평현저저우치료전（P＜0．05），대조조환자혈청CRP현저저우치료전（ P＜0．05），이총담홍소여치료전비교무명현변화；치료후，관찰조환자혈청CRP화총담홍소수평현저저우대조조（P＜0．05）。치료후，2조환자VIP저우치료전（P＜0．05），MTL수평고우치료전（P＜0．05）；치료후，관찰조VIP저우대조조（P＜0．05），MTL수평고우대조조（P＜0．05）。치료후，관찰조발열、복통、담낭종대소실시간균단우대조조（P＜0．05）。결론류산미기작용궤제가능여강저환자백세포계수、중성립세포비치、혈청CRP화총담홍소수평、VIP수평급제고MTL수평상관。
Objective To investigate the influence of magnesium sulfate on C-reactive protein, white blood cells, neutrophils, gastrointestinal function and serum bilirubin levels in patients with acute cholecystitis.Methods 117 patients with acute cholecystitis were randomly divided into two groups (n=60) and control group (n=57).The control group received conventional treatment, and observation group received conventional treatment combined with magnesium sulfate.The leukocyte count and neutrophil percentage, serum total bilirubin and CRP levels, plasma vasoactive intestinal peptide ( VIP) and motilin ( MTL) levels, and disappearance time of fever, abdominal pain, gallbladder enlargement were analysed between two groups of patients.Results After treatment, the leukocyte count and neutrophil percentage of observation group were significantly lower than those before treatment (P<0.05), but there were no significantly differences in above indexes of control group; after treatment, leukocyte count and neutrophil percentage in observation group were significantly lower than those in control group (P<0.05).After treatment, serum CRP and total bilirubin levels in observation group was significantly lower than that before treatment (P<0.05), and CRP level in control group was significantly lower than that before treatment (P<0.05), while total bilirubin level in control group showed no significant change; after treatment, the above indexes in observation group were significantly lower than that in control group (P<0.05).After treatment, plasma VIP levels in both groups was significantly lower than that before treatment, respectively (P<0.05), MTL levels were significantly higher than that before treatment, respectively (P<0.05);after treatment, VIP level was lower, MTL level was higher in observation group than that in control group, respectively (P<0.05).The disappearance time of fever, abdominal pain, gallbladder enlargement in observation group were significantly shorter than that in control group, respectively ( P<0.05 ) .Conclusion The mechanism of magnesium sulfate in the treatment of acute cholecystitis may reduce leukocyte count and neutrophil percentage, serum CRP and total bilirubin, plasma VIP level and increase MTL level.