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双氯芬酸钠对经内镜逆行胰胆管造影术后胰腺炎患者非甾体类抗炎药激活基因1水平的影响
Effect of diclofenac sodium on the level of non-steroidal anti-inflammatory drug-activated gene-1 in patients with post-ERCP pancreatitis
文章发布日期:2018年02月07日  来源:  作者:胡翠,鲍峻峻,刘晓昌,等  点击次数:748次  下载次数:57次

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【摘要】:目的探讨双氯芬酸钠对经内镜逆行胰胆管造影(ERCP)术后胰腺炎(PEP)患者非甾体类抗炎药激活基因1(NAG-1)水平的影响。方法收集2012年9月-2013年10月于安徽医科大学第一附属医院行ERCP的患者120例,随机分为双氯芬酸钠组和对照组,每组60例。双氯芬酸钠组患者ERCP术后立即肌注奥尔芬1支(含双氯芬酸钠75 mg),对照组不肌注。收集2组患者术前、术后3 h及术后24 h血液,行淀粉酶检测,并观察腹痛发生情况,计算2组患者PEP发生率。分别采用RT-PCR及Western Blot方法检测血浆中NAG-1 mRNA及蛋白表达情况。计量资料采用重复测量的方差分析,满足球形检验时,采用单变量方差分析,不满足球形检验时,采用Greenhouse-Geisser校正方法。计数资料2组间比较采用χ2检验。结果双氯芬酸钠组PEP发生率(4/60,6.67%)显著低于对照组(12/60,20.00%)(χ2=4.62,P=0.03)。双氯芬酸钠组术后3 h[(202.70±120.44)U/L vs(28357±178.39)U/L]、术后24 h[(209.13±157.14)U/L vs(30597±208.69)U/L]淀粉酶活性均低于对照组(t值分别为2.06、2.03,P值均<0.05)。同时,双氯芬酸钠组患者ERCP术后3 h 血浆中NAG-1 mRNA和蛋白表达较术前及对照组术后3 h明显升高(P值均<0.01)。结论双氯芬酸钠具有预防PEP发生的作用,可能与促进NAG-1水平相关。
【Abstract】:ObjectiveTo investigate the effect of diclofenac sodium on the level of non-steroidal anti-inflammatory drug-activated gene-1 (NAG-1) in patients with post-ERCP pancreatitis (PEP). MethodsA total of 120 patients who underwent ERCP in The First Affiliated Hospital of Anhui Medical University from September 2012 to October 2013 were enrolled and randomly divided into diclofenac sodium group and control group, with 60 patients in each group. The patients in the diclofenac sodium group were given intramuscular injection of Olfen (containing diclofenac sodium 75 mg) immediately after ERCP. Blood samples were collected before surgery and at 3 and 24 hours after surgery, and the level of amylase was measured. The incidence of abdominal pain was also observed and the incidence rate of PEP was calculated for both groups. RT-PCR and Western blot were used to measure the mRNA and protein expression of NAG-1 in plasma. An repeated-measures analysis of variance was used for comparison of continuous data; a univariate analysis of variance was used for data meeting the requirements of sphericity test, and the Greenhouse-Geisser correction method was used for data which did not meet the requirements of sphericity test. The chi-square test was used for comparison of categorical data between groups. ResultsThe diclofenac sodium group had a significantly lower incidence rate of PEP than the control group [6.67% (4/60) vs 20.00% (12/60), χ2=4.62, P=0.03]. The diclofenac sodium group had a significantly lower level of amylase than the control group at 3 and 24 hours after surgery (at 3 hours after surgery: 202.70±120.44 U/L vs 283.57±178.39 U/L, t=2.06, P<0.05; at 24 hours after surgery: 209.13±157.14 U/L vs 30597±20869 U/L, t=2.03, P<0.05). At 3 hours after ERCP, the diclofenac sodium group had significant increases in the mRNA and protein expression of NAG-1 in plasma and significantly higher mRNA and protein expression of NAG-1 than the control group (all P<001). ConclusionDiclofenac sodium can prevent PEP, possibly by promoting the level of NAG-1.
【关键字】:胰腺炎; 胰胆管造影术, 内窥镜逆行; 二氯芬酸; 非甾体类抗炎药激活基因1
【Key words】:pancreatitis; cholangiopancreatography, endoscopic retrograde; diclofenac; NSAID activated gene 1
【引证本文】:HU C, BAO JJ, LIU XC, et al. Effect of diclofenac sodium on the level of non-steroidal anti-inflammatory drug-activated gene-1 in patients with post-ERCP pancreatitis[J]. J Clin Hepatol, 2018, 34(3): 540-543. (in Chinese)
胡翠,鲍峻峻,刘晓昌,等. 双氯芬酸钠对经内镜逆行胰胆管造影术后胰腺炎患者非甾体类抗炎药激活基因1水平的影响[J]. 临床肝胆病杂志, 2018, 34(3): 540-543.

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