亚胺培南联合谷氨酰胺对重症急性胰腺炎合并感染患者甲状腺激素糖脂代谢及血清PCT水平的影响

doi:10.3969/j.issn.1002-1949.2018.06.002

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (6): 471- DOI: 10.3969/j.issn.1002-1949.2018.06.002

Effect of imipenem combined with glutamine on thyroid hormones, glycolipid metabolism and serum PCT levels in patients with severe acute pancreatitis complicated with infection

Huang Hui, Lu Wu-chang

Liuzhou People′s Hospital, Liuzhou 545006, China

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Abstract Objective To investigate the effect of imipenem combined with glutamine on thyroid hormones, glycolipid metabolism and serum procalcitonin (PCT) levels in patients with severe acute pancreatitis (SAP) complicated with infection.Methods 120 patients with SAP infection were selected as the research objects, who were divided into control group and observation group according to the stratified random grouping method, with 60 cases in each. All patients were given conventional treatment: fasting and gastrointestinal decompression, fluid resuscitation, etc. The control group was treated with imipenem with 20 mL/time, intravenous drip, 2 times/d. On the basis of the method, the study group was given glutamine with 20 g/time, intravenous drip, 1 time/d, lasting for 14 d. The levels of thyroid related hormones, glycolipid metabolism and inflammatory cytokines were detected, and the symptoms and signs returned to normal time were recorded. The clinical efficacy was compared.Results Compared with before treatment, the thyroid stimulating hormone (TSH), free three tyrosine (FT3), free four iodine tyrosine (FT4), high density lipoprotein (HDL) in the two groups were significantly increased (P<0.05), and the levels of anti three iodine (rT3) were decreased significantly (P<0.05), and the levels of white blood cell count (WBC), PCT, C reactive protein (CRP) and tumor necrosis factor-α (TNF-α), fasting blood glucose (FBP), triglyceride (TG), cholesterol (TC), low density lipoprotein (LDL) were significantly decreased (P<0.05). Compared with the control group, the levels of TSH, FT3 and FT4 in the observation group were significantly higher (P<0.05), rT3 significantly lower (P<0.05), PCT, CRP, WBC, TNF-α, FBP, TG, TC and LDL significantly lower (P<0.01), and blood and urine amylase recovery time, recovery time of bowel sound, recovery time and defecation hospitalization time were significantly shorter (P<0.01), of which the total efficiency was higher (P<0.05). Conclusion Imipenem combined with glutamine is effective in the treatment of SAP complicated with infection, and it can effectively improve the levels of thyroid hormones and PCT, which has significant clinical value.

Key words： Severe pancreatitis（SAP） Infection Imipenem Glutamine（Gln） Thyroid hormones Glycolipid metabolism

Corresponding Authors: Lu Wu-chang, E-mail: 620019772@qq.com

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Huang Hui,Lu Wu-chang. Effect of imipenem combined with glutamine on thyroid hormones, glycolipid metabolism and serum PCT levels in patients with severe acute pancreatitis complicated with infection[J]. Chinese Journal of Critical Care Medicine, 2018, 38(6): 471-.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.06.002 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I6/471

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