不同剂量乌司他丁协同谷氨酰胺治疗急性胰腺炎患者的临床效果OA

Objective:To evaluate the effects and safety of Glutamine combined with different doses of Ulinastatin in the treatment of patients with acute pancreatitis.Method:A total of 87 patients with acute pancreatitis admitted to the Third People's Hospital of Gansu Province from August 2020 to July 2023 were selected as the study subjects.According to the treatment methods,they were divided into four groups,control group(21 cases)was treated with Glutamine Injection,group A(23 cases)was treated with Glutamine+200,000 U Ulinastatin,group B(22 cases)was treated with Glutamine+400,000 U Ulinastatin,and group C(21 cases)was treated with Glutamine+600,000 U Ulinastatin.The clinical recovery progress(time of abdominal pain relief,respiratory rate recovery time,heart rate recovery time),inflammatory factors[blood amylase,C reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and the incidence of adverse reactions during treatment were compared among the four groups.The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score and the bedside index of severity in acute pancreatitis(BISAP)score before and after treatment were recorded and compared among the four groups.Result:The duration of abdominal pain relief in group B and group C were earlier than those in the control group and group A,the recovery time of respiratory rate in group B and group C were earlier than that in the control group,and the recovery time in group C was significantly earlier than that in group A,the differences were statistically significant(P<0.05).After two weeks of treatment,serum amylase,CRP and TNF-α in the four groups were decreased compared with those before treatment,serum amylase,CRP,and TNF-α levels in group A were lower than those in the control group,serum amylase,CRP,IL-6,and TNF-α levels in group B and group C were lower than those in the control group and group A,serum amylase,CRP,and TNF-α levels in group C were lower than those in group B,the differences were statistically significant(P<0.05).The incidence of adverse reactions during the treatment period did not differ significantly among the groups(P>0.05).Compared to the control group,APACHEⅡ scores and BISAP scores of patients in group B and group C decreased after two weeks of treatment(P<0.05),and both APACHEⅡ and BISAP scores in group B and group C were lower than those in group A(P<0.05).Conclusion:Glutamine combined with medium and high doses of Ulinastatin significantly improves the treatment effect of patients with acute pancreatitis,shortens recovery time,reduces inflammatory response,and has good safety.