关键词:

重症急性胰腺炎, 血必净, 血液灌流, 线粒体炎症通路, 血脂水平

Abstract:

Objective　To observe the effect of Xuebijing combined with hemoperfusion (HP) on the mitochondrial inflammatory pathway and blood lipid levels in patients with severe acute pancreatitis (SAP). Methods　One hundred patients with SAP treated at Nanyang First People's Hospital from March 2020 to January 2023 were selected for the randomized controlled trial. The patients were divided into an observation group and a control group using the random number table method, with 50 cases in each group. There were 30 males and 20 females in the observation group; they were 43-77 (60.22±5.17) years old. There were 29 males and 21 females in the control group; they were 45-75 (61.32±5.33) years old. The observation group took Xuebijing and HP, and the control group took HP. The expression levels of related proteins in the mitochondrial inflammatory pathway, blood lipid levels, and levels of inflammatory indicators before and after the treatment were compared between the two groups. t and χ² tests were applied. Results　After the treatment, the positive expression scores of formyl peptide receptor 1 (FPR1) and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) in the observation group were lower than those in the control group [(15.41±5.23) vs. (18.77±5.63) and (31.44±10.24) vs. (39.62±10.13)], with statistical differences (t=3.09 and 4.02; both P<0.05). After the treatment, the expression levels of mitochondrial ubiquitin-oxidoreductase (MT-ND) 1, MT-ND3, and MT-ND6 in the observation group were lower than those in the control group [(0.42±0.11) vs. (1.17±0.25), (1.31±0.25) vs. (1.86±0.36), and (0.92±0.45) vs. (1.44±0.27)], with statistical differences (t=19.42, 8.87, and 7.01; all P<0.05). After the treatment, the levels of total cholesterol (TC), triacylglycerol (TG), and low-density lipoprotein cholesterol (LDL-C) in the observation group were lower than those in the control group [(4.11±1.25) mmol/L vs. (5.33±1.76) mmol/L, (2.47±0.27) mmol/L vs. (3.05±0.79) mmol/L, and (1.95±0.77) mmol/L vs. (2.56±0.61) mmol/L], with statistical differences (t=4.00, 4.91, and 4.39; all P<0.05). After the treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and serum amylase (AMS) in the observation group were lower than those in the control group [(75.52±10.41) ng/L vs. (81.44±10.39) ng/L, (70.33±10.49) ng/L vs. (76.62±10.37) ng/L, and (255.36±50.61) IU/L vs. (282.45±50.11) IU/L], with statistical differences (t=2.85, 3.02, and 2.69; all P<0.05). Conclusions　Xuebijing can effectively inhibit the expression levels of mitochondrial inflammatory pathway related proteins in SAP patients; Xuebijing combined with HP can significantly reduce the patients' levels of blood lipids and inflammatory reaction.

Key words:

Severe acute pancreatitis, Xuebijing, Blood perfusion, Mitochondrial inflammatory pathway, Blood lipid levels