中国临床药理学杂志

短期胰岛素强化联合血液净化治疗高甘油三酯血症性重症急性胰腺炎的临床研究

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李海艳 ^1a , 薛方喜 ^1b , 王悦 ^1a , 鞠永静 ^1c

中国临床药理学杂志 | 临床与基础桥接研究 2026,42(8): 1095-1100

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中国临床药理学杂志 |临床与基础桥接研究 2026 , 42 (8) : 1095 -1100

短期胰岛素强化联合血液净化治疗高甘油三酯血症性重症急性胰腺炎的临床研究

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李海艳^1a, 薛方喜^1b, 王悦^1a, 鞠永静^1c

作者信息

^1a.临沂市中心医院，重症医学科，山东临沂 276400

^1b.临沂市中心医院，消化内科，山东临沂 276400

^1c.临沂市中心医院，药学部，山东临沂 276400

通讯作者:

薛方喜，副主任医师 MP: 13573915571 E-mail: xfx8582@163.com

作者简介:

李海艳（1986-），女，主治医师，主要从事重症胰腺炎的治疗方面的工作和研究

Clinical trial of short-term intensive insulin therapy combined with blood purification for hypertriglyceridemic severe acute pancreatitis

Hai-yan LI^1a, Fang-xi XUE^1b, Yue WANG^1a, Yong-jing JU^1c

Affiliations

^1a.Department of Critical Care Medicine, Linyi Central Hospital, Linyi 276400, Shandong Province, China

^1b.Department of Gastroenterology, Linyi Central Hospital, Linyi 276400, Shandong Province, China

^1c.Department of Pharmacy, Linyi Central Hospital, Linyi 276400, Shandong Province, China

出版时间: 2026-04-28 doi: 10.13699/j.cnki.1001-6821.2026.08.008

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摘要

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目的

观察短期胰岛素注射液强化联合血液净化治疗高甘油三酯血症性重症急性胰腺炎（HTG-SAP）的临床疗效和安全性。

方法

将HTG-SAP患者依据治疗方法分成对照组和试验组。对照组接受连续性血液净化（CBP）治疗，连续治疗24~48 h，间隔24 h后再行下次治疗，共治疗2次。试验组接受CBP联合0.1~0.3 U·kg^-1·h^-1胰岛素注射液持续静脉泵入。2组疗程均为7 d。比较2组患者临床疗效、临床症状缓解时间、预后指标、临床评分、血脂水平、炎症及生化因子水平，并进行安全性评价。

结果

共纳入患者78例，其中对照组41例，试验组37例。试验组和对照组的治疗总有效率分别为89.19%（33例/37例）和70.73%（29例/41例），2组间比较，在统计学上差异有统计学意义（P<0.05）。治疗后，试验组和对照组的腹胀消失时间分别为（6.27±1.10）和（6.93±1.27）d，腹痛消失时间分别为（4.97±0.80）和（5.46±1.10）d，肠鸣音恢复时间分别为（3.14±0.63）和（3.56±0.71）d，首次排便时间分别为（4.08±0.86）和（4.66±1.33）d，总住院时间分别为（17.78±3.29）和（19.54±4.15）d；器官功能衰竭恢复时间分别为（6.32±1.62）和（7.24±2.13）d，局部并发症发生率分别为8.11%（3例/37例）和26.83%（11例/41例），全身并发症发生率分别为10.81%（4例/37例）和29.27%（12例/41例）；急性胰腺炎严重程度床边指数（BISAP）评分分别为（1.51±0.51）和（1.83±0.38）分，急性生理学及慢性健康状况（APACHE Ⅱ）评分分别为（6.05±1.13）和（6.88±1.44）分；甘油三酯（TG）分别为（4.63±1.07）和（5.41±1.26）mmol·L^-1，总胆固醇（TC）分别为（4.95±1.01）和（5.73±1.27）mmol·L^-1，低密度脂蛋白胆固醇（LDL-C）分别为（2.87±0.43）和（3.15±0.56）mmol·L^-1；血淀粉酶（AMY）分别为（138.46±25.49）和（159.85±33.43）U·L^-1，白介素-8（IL-8）分别为（28.65±5.15）和（32.18±6.42）pg·mL^-1，C反应蛋白（CRP）分别为（29.88±4.81）和（33.12±6.01）mg·L^-1；上述指标，2组间比较，在统计学上差异均有统计学意义（均P<0.05）。试验组与对照组的药物不良反应发生率分别为5.41%（2例/37例）和2.44%（1例/41例），组间比较，在统计学上差异无统计学意义（P>0.05）。

结论

短期胰岛素注射液强化治疗联合血液净化可有效提高HTG-SAP患者的临床疗效，显著改善临床症状、器官功能恢复、临床评分、血脂、炎症及生化指标，降低并发症发生率，且未增加不良反应风险，具有临床应用价值。

关键词

胰岛素注射液强化治疗 / 高甘油三酯血症性重症急性胰腺炎 / 血液净化 / 临床疗效 / 炎症因子

Abstract

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Objective

To observe the clinical efficacy of short-term intensive insulin therapy combined with blood purification in the treatment of hypertriglyceridemic severe acute pancreatitis (HTG-SAP).

Methods

HTG-SAP patients were divided into control group and treatment group based on the treatment method. The control group received continuous blood purification (CBP) treatment for 24 to 48 hours, and the next treatment was performed after a 24-hour interval for a total of 2 treatments. The treatment group received continuous intravenous pumping of CBP combined with 0.1-0.3 U·kg^-1·h^-1 insulin injection. The course of treatment in both groups was 7 days. The clinical efficacy, clinical symptom relief time, prognostic indicators, clinical scores, blood lipid levels, inflammation and biochemical factor levels were compared between the two groups, and safety was evaluated.

Results

A total of 78 patients were enrolled, with 41 cases in control group and 37 cases in treatment group. The total effective rates of treatment in the treatment group and the control group were 89.19% (33 cases/37 cases) and 70.73% (29 cases/41 cases), respectively, with statistical significance differences between the two groups (P<0.05). After treatment, the disappearance times of abdominal distension in the treatment and control groups were (6.27±1.10) and (6.93±1.27) days, respectively; the disappearance times of abdominal pain were (4.97±0.80) and (5.46±1.10) days, respectively; the recovery times of bowel sounds were (3.14±0.63) and (3.56±0.71) days, respectively; the first defecation times were (4.08±0.86) and (4.66±1.33) days, respectively; the total hospitalization times were (17.78±3.29) and (19.54±4.15) days, respectively. the recovery times of organ failure were (6.32±1.62) and (7.24±2.13) days, respectively; the incidences of local complications were 8.11% (3 cases/37 cases) and 26.83% (11 cases/41 cases), respectively; the incidences of systemic complications were 10.81% (4 cases/37 cases) and 29.27% (12 cases/41 cases), respectively; the Bedside Index for Severity in Acute Pancreatitis (BISAP) scores were (1.51±0.51) and (1.83±0.38) points, respectively; the Acute physiology and chronic health evaluation scoring system (APACHE II) scores were (6.05±1.13) points and (6.88±1.44) points, respectively; triglyceride (TG) levels were (4.63±1.07) mmol·L^-1 and (5.41±1.26) mmol·L^-1, respectively; total cholesterol (TC) were (4.95±1.01) and (5.73±1.27) mmol·L^-1, respectively; low-density lipoprotein cholesterol (LDL-C) were (2.87±0.43) and (3.15±0.56) mmol·L^-1, respectively; serum amylase (AMY) levels were (138.46±25.49) and (159.85±33.43) U·L^-1, respectively; interleukin-8 (IL-8) levels were (28.65±5.15) and (32.18±6.42) pg·mL^-1, respectively; C-reactive protein (CRP) levels were (29.88±4.81) and (33.12±6.01) mg·L^-1, respectively; the differences of above indexes were all statistically significant (all P<0.05). The incidence of drug adverse reactions of the treatment group and the control group were 5.41% (2 cases/37 cases) and 2.44% (1 case/41 cases), respectively and there was no statistical significance between the two groups (P>0.05).

Conclusion

Short-term intensive insulin therapy combined with blood purification can effectively improve the clinical efficacy of HTG-SAP patients, significantly improve clinical symptoms, organ function recovery, clinical scores, blood lipids, inflammation and biochemical indicators, and does not increase the risk of adverse reactions, which has clinical application value.

Key words

intensive insulin injection therapy / hypertriglyceridemic severe acute pancreatitis / blood purification / clinical efficacy / inflammatory factors

引用本文

李海艳, 薛方喜, 王悦, 鞠永静. 短期胰岛素强化联合血液净化治疗高甘油三酯血症性重症急性胰腺炎的临床研究. 中国临床药理学杂志, 2026 , 42 (8) : 1095 -1100 . DOI: 10.13699/j.cnki.1001-6821.2026.08.008

Hai-yan LI, Fang-xi XUE, Yue WANG, Yong-jing JU. Clinical trial of short-term intensive insulin therapy combined with blood purification for hypertriglyceridemic severe acute pancreatitis[J]. Chinese Journal of Clinical Pharmacology, 2026 , 42 (8) : 1095 -1100 . DOI: 10.13699/j.cnki.1001-6821.2026.08.008

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2026年第42卷第8期

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doi: 10.13699/j.cnki.1001-6821.2026.08.008

接收时间：2026-01-30
首发时间：2026-08-06
出版时间：2026-04-28

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收稿日期：2026-01-30

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作者信息

^1a.临沂市中心医院，重症医学科，山东临沂 276400

^1b.临沂市中心医院，消化内科，山东临沂 276400

^1c.临沂市中心医院，药学部，山东临沂 276400

通讯作者:

薛方喜，副主任医师 MP: 13573915571 E-mail: xfx8582@163.com

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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