Wang Jinlong, Guo Zhanghua, Chai Xin, Li Dupeng, Su Binxiao, Jiang Peng
Xijing Hospital, Fourth Military Medical University, Department of Critical Care Medicine, Xi'an, Shaanxi Province, China.
J Med Biochem. 2025 Aug 21;44(5):1050-1058. doi: 10.5937/jomb0-55659.
This study investigated the effects of different early resuscitation fluid replenishment rates (FRRs) on inflammation (serum interleukin-6 (IL-6) and C-reactive protein (CRP), PCT and complications in patients with severe acute pancreatitis (SAP).
Sixty-six patients with SAP were studied. According to the ratio of total fluid replenishment 24 h after admission to 72 h (FRR), the patients were rolled into a low FRR group (Low group), a moderate FRR group (Moderate group), and a high FRR group (High group), with 22 cases in each. Serum-related indexes, APACHE II score, HCT, systemic inflammatory response syndrome (SIRS) duration, length of hospital stay (LOS), and complication rate (CR) were determined and compared.
The results suggested that ALT, AST, SCr, BUN, TBil, APACHE II, scores and HCT in the Moderate group were the lowest (P< 0.05), while those in the High group were the highest (P<0.05). After the patients were treated for 72 h, the IL-6, CRP and PCT in the Low and High groups were higher than those in the Moderate groups, exhibiting differences with P<0.05 and P<0.01, respectively. The SIRS duration and LOS in the Low and High groups were longer. They presented differences with P<0.05 and P<0.01 to the Moderate group, respectively. The rates of MODS, mechanical ventilation, pancreatic necrosis infection, and death in the Moderate group were the lowest (P<0.05).
the moderate FRR could effectively alleviate the inflammatory response of patients with SAP shorten the treatment time, and reduce the CR.
本研究探讨了不同早期复苏补液速率（FRR）对重症急性胰腺炎（SAP）患者炎症反应（血清白细胞介素-6（IL-6）、C反应蛋白（CRP）、降钙素原（PCT））及并发症的影响。
对66例SAP患者进行研究。根据入院后24小时至72小时的总补液量与时间的比值（FRR），将患者分为低FRR组（低组）、中FRR组（中组）和高FRR组，每组22例。测定并比较血清相关指标、急性生理与慢性健康状况评分系统II（APACHE II）评分、血细胞比容（HCT）、全身炎症反应综合征（SIRS）持续时间、住院时间（LOS）及并发症发生率（CR）。
结果显示，中组的谷丙转氨酶（ALT）、谷草转氨酶（AST）、血清肌酐（SCr）、血尿素氮（BUN）、总胆红素（TBil）、APACHE II评分及HCT最低（P<0.05），高组最高（P<0.05）。治疗72小时后，低组和高组的IL-6、CRP及PCT高于中组，差异分别为P<0.05和P<0.01。低组和高组的SIRS持续时间和LOS较长，与中组相比差异分别为P<0.05和P<0.01。中组的多器官功能障碍综合征（MODS）、机械通气、胰腺坏死感染及死亡率最低（P<0.05）。
适度的FRR可有效减轻SAP患者的炎症反应，缩短治疗时间，并降低CR。
