The effect of hemoperfusion combined with hemodiafiltration treatment on expression of serum Visfatin and Ghrelin in patients with severe acute pancreatitis
JIN Yulan1 WU Xiaoliang2
1.Department of Intensive Medicine, Dongyang Hospital of Traditional Chinese Medicine, Zhejiang Province, Dongyang 322100, China;
2.Department of Intensive Medicine, The First Affiliated Hospital of Zhejiang University, Zhejiang Province, Hangzhou 310000, China
Abstract:Objective To investagate the effect of hemoperfusion (HP) combined with hemodiafiltration (HDF) treatment on expression of serum Visfatin and Ghrelin in patients with severe acute pancreatitis (SAP). Methods From June 2015 to June 2017, 88 patients with SAP in Dongyang Hospital of Traditional Chinese Medicine were selected, and divided into control group and observation group by random number table,with 44 cases in each group. The control group was treated with HDF method on the basis of conventional treatment, and the observation group was treated with HP combined with HDF method on the basis of conventional treatment. The serum was collected at admission, the first, seventh and fourteenth days of hospitalization. The biochemical parameters, Ghrelin, Visfatin levels between two groups were compared, and the gastrointestinal function recovery time, abdominal pain relief time and evacuation of ventilator time of two groups were compared. Results At admission, the first, seventh and fourteenth days of hospitalization, the tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), Visfatin and Ghrelin levels in both groups were all decreased gradually, the difference were highly statistically significant (P < 0.01). The TNF-α, CRP, IL-6, Visfatin and Ghrelin levels of patients in both groups on the seventh and fourteenth days of hospitalization were compared with that at admission and the first days of hospitalization, the difference were statistically significant (P < 0.05). The TNF-α, CRP, IL-6, Visfatin and Ghrelin levels in observation group on the seventh and fourteenth days of hospitalization were lower than those control group, the difference were statistically significant (P < 0.05). The gastrointestinal function recovery time, abdominal pain relief time and evacuation of ventilator time in observation group were lower than those control group, the difference were highly statistically significant (P < 0.01). Conclusion HP combined with HDF can effectively relieve the inflammatory response in patients and reduce the expression level of visfatin Ghrelin, and the clinical effect is good.
金宇兰1 吴晓梁2. 血液灌流联合血液透析滤过治疗对重症急性胰腺炎患者血清Visfatin、Ghrelin表达的影响[J]. 中国医药导报, 2018, 15(7): 82-85,102.
JIN Yulan1 WU Xiaoliang2. The effect of hemoperfusion combined with hemodiafiltration treatment on expression of serum Visfatin and Ghrelin in patients with severe acute pancreatitis. 中国医药导报, 2018, 15(7): 82-85,102.
[1] Razavi D,Lindblad M,Bexelius T,et al. Polypharmacy and risk of acute pancreatitis [J]. Pharmacoepidemiol Drug Saf,2016,25(11):1337-1341.
[2] Kirchner J,Lorenz F,Vlahovic J,et al. Spontaneously reversible portal vein thrombosis complicating acute pancreatits--computed tomographic findings [J]. Rontgenpraxis,2008,56(5):191-194.
[3] Dick JF,Gardner TB,Merrens EJ. Acute pancreatitis:new developments and strategies for the hospitalist [J]. J Hosp Med,2016,11(10):724-729.
[4] 孙俊涛,许刚.细胞因子与重症急性胰腺炎关系研究进展[J].临床消化病杂志,2008,20(5):315-317.
[5] Daniel P,Le■niowski B,Mokrowiecka A,et al. Circulating levels of visfatin,resistin and pro-inflammatory cytokine interleukin-8 in acute pancreatitis [J]. Pancreatology,2010, 10(4):477-482.
[6] Jaworek J,Konturek SJ. Hormonal protection in acute pancreatitis by ghrelin,leptin and melatonin [J]. World J Gastroenterol,2014,20(45):16 902-16 912.
[7] Kanat BH,Ayten R,Ayd?覦n S,et al. Significance of appetite hormone ghrelin and obestatin levels in the assessment of the severity of acute pancreatitis [J]. Turk J Gastroenterol,2014,25(3):309-313.
[8] 梅鹏飞,黄梅芳,孔浩,等.急性胰腺炎患者血清内脂素变化与病情相关性研究[J].中华胰腺病杂志,2015,15(1):44-45.
[9] 中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南(草案)[J].中华消化杂志,2004,24(3):190.
[10] Singh P,Garg PK. Pathophysiological mechanisms in acute pancreatitis:current understanding [J]. Indian J Gastroenterol,2016,35(3):153-166.
[11] Lee JK. Recent advances in management of acute pancreatitis [J]. Korean J Gastroenterol,2015,66(3):135-143.
[12] Wang LZ,Luo MY,Zhang JS,et al. Effect of ulinastatin on serum inflammatory factors in Asian patients with acute pancreatitis before and after treatment:a meta-analysis [J]. Int J Clin Pharmacol Ther,2016,54(11):890-898.
[13] Gillies N,Pendharkar SA,Asrani VM,et al. Interleukin-6 is associated with chronic hyperglycemia and insulin resistance in patients after acute pancreatitis [J]. Pancreatology,2016,16(5):748-755.
[14] 杨晓娟,李丽霞,王淑贤,等.血液灌流与血液透析滤过联用治疗重症急性胰腺炎合并急性肾功能衰竭[J].中华危重病急救医学,2007,19(8):476.
[15] Ishigaki S,Fukasawa H,Kinoshita-Katahashi N,et al. Caffeine intoxication successfully treated by hemoperfusion and hemodialysis [J]. Intern Med,2014,53(23):2745-2747.
[16] Ronco C. Hemodiafiltration:technical and clinical issues [J]. Blood Purif,2015,40(Suppl 1):2-11.
[17] 陈中建,苟菲,张天锋,等.肺部感染对重症急性胰腺炎患者呼吸功能及外周血炎症因子的影响[J].中华医院感染学杂志,2017,27(9):2050-2053.
[18] 郭明浩.急性胰腺炎血清hs-CRP、NGAL和ghrelin水平监测及意义[J].中国现代普通外科进展,2017,20(3):227-229.
[19] 方春芸,唐国都,梁志海,等.Ghrelin及GHSR在急性坏死性胰腺炎大鼠胰腺组织的表达[J].中华胰腺病杂志,2012,12(6):384-387.
[20] Nergiz AS,Altinkaya SO,Kü?觭ük M,et al. Visfatin concentrations in patients with endometrial cancer [J]. Gynecol Endocrinol,2015,31(3):202-207.