Xue Ping, Deng Li-Hui, Xia Qing, Zhang Zhao-Da, Hu Wei-Ming, Yang Xiao-Nan, Song Bing, Huang Zong-Wen
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
World J Gastroenterol. 2008 Jan 21;14(3):474-8. doi: 10.3748/wjg.14.474.
To evaluate the therapeutic effect of alanyl-glutamine dipeptide (AGD) in the treatment of severe acute pancreatitis (SAP) in early and advanced stage.
Eighty patients with SAP were randomized and received 100 mL/d of 20% AGD intravenously for 10 d starting either on the day of (early treatment group) or 5 d after (late treatment group) admission. Groups had similar demographics, underlying diseases, Ranson score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Balthazar's computed tomography (CT) score at the beginning of the study and underwent similar other medical and nutritional management.
The duration of acute respiratory distress syndrome (2.7 +/- 3.3 d vs 12.7 +/- 21.0 d, P < 0.01), renal failure (1.3 +/- 0.5 d vs 5.3 +/- 7.3 d, P < 0.01), acute hepatitis (3.2 +/- 2.3 d vs 7.0 +/- 7.1 d, P < 0.01), shock (1.7 +/- 0.4 d vs 4.8 +/- 3.1 d, P < 0.05), encephalopathy (2.3 +/- 1.9 d vs 9.5 +/- 11.0 d, P < 0.01) and enteroparalysis (2.2 +/- 1.4 d vs 3.5 +/- 2.2 d, P < 0.01) and hospital stay (28.8 +/- 9.4 d vs 45.2 +/- 27.1 d, P < 0.01) were shorter in the early treatment group than in the late treatment group. The 15-d APACHE II score was lower in the early treatment group than in the late treatment group (5.0 +/- 2.4 vs 8.6 +/- 3.6, P < 0.01). The infection rate (7.9% vs 26.3%, P < 0.05), operation rate (13.2% vs 34.2%, P < 0.05) and mortality (5.3% vs 21.1%, P < 0.05) in the early treatment group were lower than in the late treatment group.
Early treatment with AGD achieved a better clinical outcome in SAP patients.
评估丙氨酰谷氨酰胺二肽（AGD）对早期和晚期重症急性胰腺炎（SAP）的治疗效果。
80例SAP患者被随机分组，自入院当天（早期治疗组）或入院5天后（晚期治疗组）开始，静脉输注100 mL/d的20%AGD，共10天。两组在研究开始时的人口统计学特征、基础疾病、兰森评分、急性生理与慢性健康状况评分系统II（APACHE II）评分及巴尔萨泽计算机断层扫描（CT）评分相似，且接受相似的其他医疗和营养管理。
早期治疗组急性呼吸窘迫综合征持续时间（2.7±3.3天对12.7±21.0天，P<0.01）、肾衰竭（1.3±0.5天对5.3±7.3天，P<0.01）、急性肝炎（3.2±2.3天对7.0±7.1天，P<0.01）、休克（1.7±0.4天对4.8±3.1天，P<0.05）、脑病（2.3±1.9天对9.5±11.0天，P<0.01）和肠麻痹（2.2±1.4天对3.5±2.2天，P<0.01）以及住院时间（28.8±9.4天对45.2±27.1天，P<0.01）均短于晚期治疗组。早期治疗组第15天的APACHE II评分低于晚期治疗组（5.0±2.4对8.6±3.6，P<0.01）。早期治疗组的感染率（7.9%对26.3%，P<0.05）、手术率（13.2%对34.2%，P<0.05）和死亡率（5.3%对21.1%，P<0.05）均低于晚期治疗组。
AGD早期治疗可使SAP患者获得更好的临床疗效。
