Wang Su-Qin, Jiao Wei, Zhang Jing, Zhang Ju-Fen, Tao Yun-Na, Jiang Qing, Yu Feng
Department of General Surgery, The 904 Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China.
Department of Nursing, The 904 Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China.
World J Clin Cases. 2023 Jul 6;11(19):4601-4611. doi: 10.12998/wjcc.v11.i19.4601.
Severe acute pancreatitis (AP) is one of the most common diseases of the gastrointestinal tract and carries a significant financial burden with high disability and mortality. There are no effective drugs in the clinical management of severe AP, and there is an absence of evidence-based medicine concerning the treatment of severe AP.
To explore whether ulinastatin (UTI) can improve the outcome of severe AP.
The present research included patients who were hospitalized in intensive critical care units (ICUs) after being diagnosed with severe AP. Patients received UTI (400000 IU) or placebos utilizing computer-based random sequencing (in a 1:1 ratio). The primary outcome measures were 7-d mortality, clinical efficacy, inflammatory response, coagulation function, infection, liver function, renal function, and drug-related adverse effects were evaluated.
A total of 181 individuals were classified into two groups, namely, the placebo group ( = 90) and the UTI group ( = 91). There were no statistically significant differences in baseline clinical data between the two groups. The 7-d mortality and clinical efficacy in the UTI group were remarkably improved compared with those in the placebo group. UTI can protect against hyperinflammation and improve coagulation dysfunction, infection, liver function, and renal function. UTI patients had markedly decreased hospital stays and hospitalization expenditures compared with the placebo group.
The findings from the present research indicated that UTI can improve the clinical outcomes of patients with severe AP and has fewer adverse reactions.
重症急性胰腺炎（AP）是最常见的胃肠道疾病之一，具有较高的致残率和死亡率，带来了巨大的经济负担。在重症急性胰腺炎的临床治疗中，尚无有效的药物，且缺乏关于其治疗的循证医学依据。
探讨乌司他丁（UTI）是否能改善重症急性胰腺炎的治疗效果。
本研究纳入了被诊断为重症急性胰腺炎后入住重症监护病房（ICU）的患者。患者通过计算机随机序列法接受UTI（400000IU）或安慰剂治疗（比例为1:1）。评估主要结局指标包括7天死亡率、临床疗效、炎症反应、凝血功能、感染、肝功能、肾功能以及药物相关不良反应。
共181例患者被分为两组，即安慰剂组（n = 90）和UTI组（n = 91）。两组间基线临床数据无统计学显著差异。与安慰剂组相比，UTI组的7天死亡率和临床疗效显著改善。UTI可预防过度炎症反应，改善凝血功能障碍、感染、肝功能和肾功能。与安慰剂组相比，UTI组患者的住院时间和住院费用显著降低。
本研究结果表明，UTI可改善重症急性胰腺炎患者的临床结局，且不良反应较少。
