目的 研究谷氨酰胺聯(lián)合生長(zhǎng)抑素對(duì)急性胰腺炎患者肝功能的影響。方法 選擇2015年1月-2017年12月安徽省第二人民醫(yī)院急診醫(yī)學(xué)科收治的50例急性胰腺炎患者，隨機(jī)分為對(duì)照組（n=25）和觀察組（n=25）。對(duì)照組將6 mg生長(zhǎng)抑素加入至500 mL生理鹽水中進(jìn)行靜脈滴注，每天1次。觀察組在對(duì)照組基礎(chǔ)上聯(lián)合靜脈滴注谷氨酰胺，每次20 g，每天1次。兩組均給藥7 d。記錄兩組的機(jī)械通氣時(shí)間、APACHE Ⅱ評(píng)分及住院時(shí)間，比較兩組肝功能和血清炎性細(xì)胞因子水平。結(jié)果 觀察組的有效率為92.00%，明顯高于對(duì)照組的76.00%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組機(jī)械通氣時(shí)間、APACHE Ⅱ評(píng)分及住院時(shí)間均明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的天冬氨酸氨基轉(zhuǎn)移酶（AST）、總膽紅素（TBIL）和丙氨酸氨基轉(zhuǎn)移酶（ALT）均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組以上指標(biāo)明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的白介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、白介素-8（IL-8）、超敏C反應(yīng)蛋白（hs-CRP）均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組以上指標(biāo)明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 谷氨酰胺聯(lián)合生長(zhǎng)抑素可以有效改善急性胰腺炎患者的肝功能，抑制炎癥反應(yīng)，效果明顯優(yōu)于單用生長(zhǎng)抑素。

Objective To investigate the effect of somatostatin combined with glutamine on liver function in patients with acute pancreatitis.Methods Selected 50 cases of patients with acute pancreatitis who were treated in our hospital from January 2015 to December 2017,divided into the control group (n=25),and the observation group (n=25).The mechanical ventilation time,APACHE Ⅱ score and hospitalization time were recorded,and the liver function and serum inflammatory cytokine levels were compared before and after treatment.Results The effective rate of the observation group was 92.00%,which was significantly higher than that of the control group (76.00%,P<0.05).The duration of mechanical ventilation,APACHE Ⅱ score and hospitalization time in the observation group were significantly lower than those in the control group (P<0.05).After treatment,aspartate aminotransferase (AST),total bilirubin (TBIL) and alanine aminotransferase (ALT) in the two groups were significantly decreased,and there was significant difference before and after treatment in the same group (P<0.05);and the above indicators in the observation group were significantly lower than those in the control group (P<0.05).After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-alpha (TNF-alpha),interleukin-8(IL-8),and acute C-reactive protein (hs-CRP) in the two groups were significantly lower than those in the control group (P<0.05),and the above indexes in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Somatostatin combined with glutamine can effectively improve liver function and inhibit inflammatory reaction in patients with acute pancreatitis,and the effect is better than somatostatin alone.