ABSTRACT
Objective To investigate the effects of ulinastatin combined with octreotide in patients with severe acute pancreatitis TAP, SAA and serum inflammatory factors. Methods From February 2011 to September 2016,one hundred and seventy-eight patients with severe acute pancreatitis treated in the Second Affiliated Hospital of Hainan Medical University were enrolled in the study and were divided into the control group(81 cases) and observation group (97 cases). On the basis of routine treatment,the control group was treated with 0. 50 mg octreotide +0. 9% sodium chloride injection,continuous intravenous infusion at 20 mg/h, and 1 time /d,with a total of 3 d. On the basis of the control group,the observation group was given ulinastatin 100 thousand U+250 ml 0. 9% sodium chloride solution intravenous drip,2 times /d,with a total of 3 d. Before and after treatment,TAP,SAA and serum inflammatory factors in two groups were detected and analyzed. Results The levels of TAP,SAA,lipase and amylase in the observation group were (45. 21±9. 64) nmol/L,(458. 62 ±75. 41) mg/L, ( 14731. 7 ± 812. 5) U/L and ( 9341. 3 ± 831. 3) U/L respectively, compared with ( 26. 38 ±7. 13) nmol/L, ( 201. 23 ± 64. 31 ) mg/L, ( 10 321. 4 ± 762. 8) U/L and ( 5 416. 7 ± 306. 8) U/L after treatment. Before treatment,the control group were (43. 14±8. 53) nmol/L,(463. 71±62. 83) mg/L,(13826. 2 ±731.3) U/L and (9126.4±835.1) U/L,and the control group were (37.41±8.32) nmol/L,(316.42 ±68. 71) mg/L,(12 318. 5±797. 3) U/L and (7 423. 1±752. 3) U/L. After treatment,the two groups were lower than those before treatment (P＜0. 05),and the decrease was more obvious in the observation group after treatment. Compared with the control group,the difference was statistically significant ( P＜0. 05) . The level of calcitonin,C reactive protein and triglyceride in the observation group were ( 6. 04 ± 1. 25) ng/mL, ( 237. 3 ±13. 2) mg/L and ( 32. 18 ± 1. 32) mmol/L respectively before treatment. After treatment, they were ( 2. 37 ±0. 96) ng/mL,(48. 9±11. 2) mg/L and (12. 73±3. 61) mmol/L. Before treatment,the control group was (5. 72 ± 1. 43 ) ng/mL, ( 213. 1 ± 16. 2 ) mg/L, ( 30. 76 ± 1. 94 ) mmol/L and ( 5. 32 ± 1. 21 ) mmol/L, respectively. After treatment,they were (4. 21±1. 32) ng/mL,(156. 2±14. 7) mg/L and (24. 69±1. 26) mmol/L respectively. The levels of calcitonin,C reactive protein and triglyceride in the two groups were lower than those before treatment (P＜0. 05),and the decrease was more obvious in the observation group after treatment,and the difference was statistically significant compared with the control group. (P＜0. 05); tn the observation group,the levels of interleukin 6,interleukin 8,TNF - alpha,thromboxane and prostacyclin were (292. 48±19. 57) ng/L, (105. 52 ± 11. 41 ) ng/L, ( 4. 31 ± 0. 58 ) ng/L, ( 442. 16 ± 40. 23 ) ng/L and ( 167. 42 ± 12. 29 ) ng/L respectively.After treatment,they were (67.43±9.21) ng/L,(23.19±3.26) ng/L,(1.27±0.32) ng/L, (192. 20± 16. 89) ng/L and ( 364. 57 ± 27. 02) ng/L respectively. Before treatment, the control group was (278. 31±22. 49) ng/L,(113. 21±11. 45) ng/L,(4. 32±0. 48) ng/L,(428. 32±36. 54) ng/L and (159. 31 ±13. 42) ng/L,compared with (125. 74±16. 52) ng/L,(67. 21±7. 65) ng/L,(3. 16±0. 29) ng/L,(321. 46 ±25. 51) ng/L,(246. 73±20. 52) ng/L after treatment. After treatment,the levels of IL-6,IL-8,TNF-alpha and thromboxane in the two groups were all lower than those before the treatment ( P＜0. 05 ) . The levels of prostacyclin in the two groups were all higher than those before treatment ( P＜0. 05) . Conclusion Ulinastatin combined with octreotide in the treatment of severe acute pancreatitis can reduce the level of blood lipid,reduce inflammatory factors,reduce systemic inflammatory response, improve the patient's inhibition of inflammatory response and promote the balance of inflammatory reaction, and test the patient's TAP, SAA and serum inflammatory response factors to the diagnosis of SAP and the judgment of the disease,and have certain clinical guidance.