Zhao Li, Ma Yanrong, Li Qiuyue, Wang Yuhan
Department of Gastroenterology and Hepatology, Tangshan Gongren Hospital Tangshan 063000, Hebei Province, China.
Department of Oncology, The Central Hospital Tangshan 064100, Hebei Province, China.
Am J Transl Res. 2022 Feb 15;14(2):918-926. eCollection 2022.
To explore whether ulinastatin combined with glutamine (Gln) can improve the liver function and inflammation in patients with severe acute pancreatitis (SAP).
Altogether 78 patients with SAP treated in Tangshan Workers' Hospital were retrospectively enrolled and divided into the control group (CG, n=35, conventional treatment plus ulinastatin) and the research group (RG, n=43, additional Gln on the basis of treatment in the CG) according to the treatment regimen. The improvement of clinical symptoms after treatment was observed in both groups. The levels of IgM, IgA and IgG were tested by ELISA. The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were utilized to evaluate the changes of the patients' condition before and after treatment, and the Balthazar CT score was used to assess the changes of the lesions. The changes of inflammatory cytokines were determined via Enzyme linked immunosorbent assay (ELISA). The liver function and amylase indexes of both groups were measured.
Patients in the RG experienced faster improvement in bloating and abdominal pain, first defecation, and bowel sound recovery than the CG (all P<0.05). After treatment, IgM, IgA and IgG in the RG were higher than those in the CG (all P<0.05). Besides, the RG exhibited markedly lower interleukin-6 (IL6), IL, tumor necrosis factor α (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) levels than the CG after treatment (all P<0.05). After treatment, the indexes of liver function and amylase in both groups were decreased, and those in the RG were lower than those in the CG (all P<0.05).
Ulinastatin in combination with glutamine is effective in treating severe pancreatitis, which efficiently reduces inflammation in patients and facilitates the recovery of immune, metabolic, and liver functions, and therefore it has a high clinical application value.
探讨乌司他丁联合谷氨酰胺（Gln）能否改善重症急性胰腺炎（SAP）患者的肝功能及炎症状态。
回顾性纳入唐山市工人医院收治的78例SAP患者，根据治疗方案分为对照组（CG，n = 35，常规治疗加乌司他丁）和研究组（RG，n = 43，在CG治疗基础上加用Gln）。观察两组治疗后临床症状的改善情况。采用酶联免疫吸附测定法（ELISA）检测IgM、IgA和IgG水平。利用急性生理与慢性健康状况评分系统（APACHE）Ⅱ评分评估患者治疗前后病情变化，采用巴尔萨泽CT评分评估病变变化。通过ELISA测定炎症细胞因子的变化。检测两组的肝功能及淀粉酶指标。
RG患者腹胀、腹痛、首次排便及肠鸣音恢复较CG更快（均P < 0.05）。治疗后，RG患者的IgM、IgA和IgG高于CG（均P < 0.05）。此外，治疗后RG患者的白细胞介素-6（IL6）、IL、肿瘤坏死因子α（TNF-α）和高敏C反应蛋白（hs-CRP）水平明显低于CG（均P < 0.05）。治疗后，两组肝功能及淀粉酶指标均降低，且RG低于CG（均P < 0.05）。
乌司他丁联合谷氨酰胺治疗重症胰腺炎疗效显著，能有效减轻患者炎症，促进免疫、代谢及肝功能恢复，具有较高的临床应用价值。
