Clinical study on melatonin combined with alprostadil in the treatment of patients with acute pancreatitis / 中国医师进修杂志

ABSTRACT

Objective To observe the results of melatonin combined with alprostadil in the treatment of patients with acute pancreatitis.Methods Seventy patients with acute pancreatitis were included in the study,14 patients died after conventional treatment were set to group Ⅰ ,28 patients cured after conventional treatment were set to group Ⅱ and 28 cases cured after melatonin combined with alprostadil and conventional treatment were set to group Ⅲ.White blood cell count,blood gas analysis,serum amylase,endotoxin and malondialdehyde (MDA) content was detected at 6 h,48 h and 4 d.Results White blood cell count,serum amylase,endotoxin,MDA content at 6 h,48 h and 4 d in group Ⅰ were higher than those in group Ⅱ ,Ⅲ (P＜0.05).Endotoxin levels reached a maximum in the 4 d [(273.5 ± 20.4) pg/L],and MDA content reached a maximum in the 4 d [(5.12 ± 0.87) μmol/L].White blood cell count,partial pressure of carbon dioxide in artery (PaCO2),serum amylase,endotoxin and MDA content at 48 h,4 d in group Ⅲ were lower than those in group Ⅰ,Ⅱ (P <0.05).Conclusions Melatonin combined with alprostadil not only shows antioxidant,anti-inflammatory,anti-apoptotic effect but also improves the pancreas,lung,small intestine microcirculation,protects the cell membrane and the lysosomal membrane,and prevents effectively the pancreatic digestive enzymes release; also it inhibits intestinal bacterial translocation,reduces the generation of gut-derived endotoxin and pro-inflammatory cytokine release.It can reduce effectively the systemic inflammatory response in acute pancreatitis.