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Effect of ulinastatin combined with early enteral nutrition on severe acute pancreatitis and its effect on nuclear factor-κB and Toll-like receptor 4 / 中国医师进修杂志
Chinese Journal of Postgraduates of Medicine ; (36): 153-157, 2021.
Article in Chinese | WPRIM | ID: wpr-883411
ABSTRACT

Objective:

To study the effect of ulinastatin combined with early enteral nutrition on severe acute pancreatitis and its effect on nuclear factor-κB(NF-κB) and Toll-like receptor 4 (TLR4).

Methods:

Ninety severe acute pancreatitis patients who were treated in Central Hospital of Lijin County from January 2016 to January 2020 were selected and were divided into U+EEN group (ulinastatin combined with early enteral nutrition therapy) and EEN group (early enteral nutrition therapy) by random number table method, with 45 patients in each group. Curative effect, complications, nutritional indicators, immunoglobulins and inflammatory factors were detected and compared with analysis of variance. Western blot was used to detect the expression of NF-κB and TLR4 in pancreatic tissue in two groups.

Results:

The hospitalization time, ICU admission time, intestinal ventilation time, hospitalization costs and organ failure rate, pancreatic cysts, diabetes, chronic pancreatitis, incidence of sepsis in U + EEN group were lower than those in EEN group (2.1 ± 0.4) months vs. (2.4 ± 0.6) months, (16.9 ± 2.1) d vs. (21.7 ± 2.8) d, (23.7 ± 3.8) d vs. (27.4 ± 4.1) d, (11.4 ± 1.5) thousand Yuan vs. (14.1 ± 2.1) thousand Yuan and 8.9%(4/45) vs. 20.0%(9/45), 13.3%(6/45) vs. 28.9%(13/45), 11.1%(5/45) vs. 24.4%(11/45), 8.9%(4/45) vs. 26.7%(12/45), 6.7%(3/45) vs. 22.2%(10/45), and the differences were statistically significant ( P<0.05). The levels of prealbumin (PA), albumin (ALB) and total protein (TP) after treatment in U + EEN group were higher than those in EEN group (107.4 ± 6.5) mg/L vs. (102.8 ± 4.7) mg/L, (46.1 ± 3.5) g/L vs. (43.4 ± 2.8) g/L, (55.9 ± 3.4) g/L vs. (53.7 ± 3.1) g/L, and the differences were statistically significant ( P<0.05). The levels of IgG, IgA, IgM after treatment in U+EEN group were higher than those in EEN group (10.5 ± 1.6) g/L vs. (9.5 ± 1.3) g/L, (8.9 ± 1.4) mg/L vs. (8.3 ± 1.2) mg/L, (60.5 ± 3.6) mg/L vs. (55.9 ± 3.4) mg/L, the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 in U+EEN group were lower than those in EEN group (25.1 ± 2.9) mg/L vs. (30.6 ± 4.1) mg/L, (20.1 ± 1.9) mg/L vs. (24.6 ± 1.5) mg/L, (17.8 ± 1.9) mg/L vs. (20.1 ± 2.3) mg/L, and the differences were statistically significant ( P<0.05). The expressions of NF-κB and TLR4 protein in pancreatic tissue of patients in U + EEN group were significantly lower than those in EEN group (0.3 ± 0.2 vs. 0.5 ± 0.2, 0.2 ± 0.1 vs. 0.5 ± 0.1, P<0.05).

Conclusions:

Ulinastatin combined with early enteral nutrition can significantly improve the nutritional status and immune function and improve the prognosis of patients with severe acute pancreatitis, which may be related to ulinastatin′s reduction effect of NF-κB and TLR4′s expressions.
Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Postgraduates of Medicine Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Postgraduates of Medicine Year: 2021 Type: Article