Effect of Ulinastatin on Platelet Parameters in Elderly Patients with Moderately Severe and Severe Acute Pancreatitis / 胃肠病学

ABSTRACT

BacKground:The deveIopment of acute pancreatitis( AP ) is often accompanied by pancreatic microcircuIation disturbance and aIterations in bIood coaguIation and fibrinoIytic systems, which resuIts in abnormaIities of pIateIet parameters. Aims:To investigate the changes of pIateIet parameters in eIderIy AP patients and the effect of uIinastatin ( UTI)on pIateIet parameters and disease status. Methods:Two hundred and seventeen eIderIy AP patients(≥60 years) were enroIIed retrospectiveIy from Aug. 2009 to Dec. 2013 at the First AffiIiated HospitaI of Nanjing MedicaI University. According to the severity of the disease,patients were divided into three groupsmiId AP( MAP),moderateIy severe AP ( MSAP),and severe AP( SAP). The pIateIet parameters,incIuding PLT,MPV and PDW before and after treatment,as weII as the differences in pIateIet parameters and cIinicaI efficacy between conventionaI therapy and UTI therapy were compared and anaIyzed. Results:In MSAP and SAP groups,PLT at admission was significantIy Iower(P<0. 01),whiIe MPV and PDW were significantIy higher(P<0. 05)than those in MAP group. After 1-week treatment,PLT increased significantIy(P<0. 01)and MPV and PDW decreased significantIy(P<0. 05)in MSAP and SAP groups. UTI therapy was superior to conventionaI therapy in increasing PLT( P <0. 01 ),decreasing MPV and PDW( P <0. 01 ),and improving the overaII efficacy in MSAP and SAP groups( MSAP92. 3% vs. 81. 2%,P <0. 01;SAP90. 0% vs. 80. 8%,P<0. 01). Conclusions:Changes of pIateIet parameters in eIderIy MSAP and SAP patients are different from those in MAP patients,which might refIect the disease severity. UTI is effective in reducing the activity of pIateIet and can be used in the treatment and prevention of disease progression in eIderIy AP patients.