Somatostatin combined with alanyl-glutamine in the treatment of severe pneumonia in the elderly:clinical efficacy and impact on DAO,CRP,and ACTH
Objective To explore the clinical efficacy of somatostatin combined with alanyl-glutamine in the treatment of se-vere pneumonia in the elderly and its impact on the levels of diamine oxidase(DAO),C-reactive protein(CRP),and adreno-corticotropic hormone(ACTH),aiming to provide a reference for the treatment of elderly patients with severe pneumonia.Methods A total of 102 elderly patients with severe pneumonia admitted to Suining Municipal Hospital of TCM from March 2020 to March 2022 were selected and allocated to a control group(n=48)and a study group(n=54)based on the treat-ment plan.The control group was treated with alanyl-glutamine in addition to symptomatic treatment,while the study group was treated with somatostatin in addition to the control group's treatment.The clinical efficacy,intestinal function,inflammatory stress status,pulmonary surfactant protein-A(SP-A),pulmonary surfactant protein-D(SP-D)levels,and adverse reaction occurrence were compared between the two groups.Results The overall response rate of treatment in the study group was significantly higher than that in the control group[90.74％(49/54)vs.72.92％(35/48);x2=5.555,P=0.018].Before treatment,no significant differences were noted in the urinary lactulose/mannitol(L/M)ratio,serum DAO,D-lactate,and bacterial endotoxin(BE)levels between the two groups(P＞0.05);after treatment,these levels were all decreased,and the study group had lower levels than the control group,with significant differences(P＜0.05).Before treatment,no significant differences were noted in the serum CRP,interleukin-6(IL-6),ACTH,and cortisol(COR)levels between the two groups(P＞0.05);after treatment,these levels were all decreased,and the study group had lower levels than the control group,with significant differences(P＜0.05).Before treatment,no significant differences were observed in the serum SP-A and SP-D levels between the two groups(P＞0.05);after treatment,these levels all showed an increase,and the study group had higher levels than the control group,with significant differences(P＜0.05).There was no statisti-cally significant difference in the incidence of adverse reactions between the two groups(x2=0.018,P=0.893).Conclusion The combination of somatostatin and alanyl-glutamine in the treatment of elderly patients with severe pneumonia has an ideal clinical efficacy,helps protect intestinal function,effectively reduces systemic inflammatory responses,improves pulmonary function,and does not increase the risk of adverse reactions,providing a more comprehensive and effective reference for the comprehensive treatment of elderly patients with severe pneumonia.
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