生长抑素治疗对胆道感染致脓毒症患者免疫功能、肠功能及预后转归的影响

徐鑫　郑高明　 武伟　柴立新　朱全力　李杭

[關键词] 生长抑素;胆道感染致脓毒症;肠屏障功能;免疫功能;预后转归

[中图分类号] R656.7          [文献标识码] B          [文章编号] 1673-9701（2021）22-0123-05

Effect of somatostatin therapy on immune function， intestinal function and prognosis of patients with sepsis caused by biliary tract infection

XU Xin1   ZHENG Gaoming2   WU Wei1   CHAI Lixin1   ZHU Quanli1   LI Hang1

1.Department of Gastrointestinal， Hepatobiliary， Spleen and Pancreatic Surgery， Affiliated Hospital of Hangzhou Normal University， Hangzhou  310015， China; 2.Department of Laboratory Medicine， Affiliated Hospital of Hangzhou Normal University， Hangzhou   310015， China

[Abstract] Objective To investigate the effect of somatostatin therapy on immune function， intestinal function and prognosis of patients with sepsis caused by biliary tract infection. Methods A total of 84 patients with sepsis caused by biliary tract infection treated in our hospital from July 2019 to November 2020 were selected and divided into the basic treatment group and the somatostatin group using random number table method， with 42 patients in each group. The basic treatment group were given conventional treatment， and the somatostatin group were given somatostatin in addition to the basic treatment. The intestinal barrier function， immune function and prognosis of the two groups were compared. Results There were no significant differences in the levels of D lactic acid， diamine oxidase， endotoxin and procalcitonin between the two groups on admission and at 1 day after admission （P>0.05）. At 1 day after admission， the level of endotoxin in the somatostatin group was significantly lower than that at admission（P<0.05）. At 2， 3 and 7 days after admission， the levels of D lactic acid， diamine oxidase， endotoxin and procalcitonin in the two groups were significantly lower than those at admission（P<0.05）， and those in the somatostatin group were significantly lower than those in the basic treatment group （P<0.05）. After treatment， the levels of CD4+/CD8+， immunoglobulin G and immunoglobulin M in the two groups were significantly higher than those before treatment（P<0.05）， and those in the somatostatin group were significantly higher than those in the basic treatment group （P<0.05）. After treatment， the estimated scores of sequential organ failure， and acute physiology and chronic health status scores of the two groups were significantly lower than those before treatment （P<0.05）， and those in the somatostatin group were significantly lower than those in the basic treatment group （P<0.05）. The hospital stay in the intensive care unit of the somatostatin group was significantly shorter than that of the basic treatment group （P<0.05）. There was no significant difference in 28-day mortality between the two groups （P>0.05）. Conclusion Somatostatin can effectively improve the intestinal barrier function and immune function of patients with sepsis caused by biliary tract infection and promote the prognosis.