Clinical trial of octreotide combined with ulinastatin in the treatment of patients with acute pancreatitis
Objective To observe the effects of octreotide combined with ulinastatin on hemorheology,serum inflammatory factors and serum soluble tumor necrosis factor receptor(sTNF-R)level in patients with acute pancreatitis(AP).Methods Patients with AP were divided into the control group and the treatment group.The control group was treated with intravenous infusion of octreotide acetate injection,0.3 mg each time,bid.On this basis,the treatment group was treated with of ulinastatin injection 1.0 x 105 U,bid.Clinical effects,the time for abdominal pain relief,time to first bowel movement,time for gastrointestinal decompression,length of hospital stay,hemorheology(whole blood high shear viscosity,plasma specific viscosity and platelet adhesion rate),serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-6(IL-6),interleukin-8(IL-8)]and sTNF-R level were compared between the groups.The safety was evaluated.Results There were 40 cases in the treatment group and 40 cases in the control group.After treatment,the total effective rates in the treatment group and the control group were 85.00％(34 cases/40 cases)and 65.00％(26 cases/40 cases),and the difference was statistically significant(P＜0.05).After treatment,the relief time of abdominal pain in the treatment group and the control group were(1.29±0.33)and(1.68±0.45)d;time of first bowel movement were(2.93±0.65)and(3.30±0.72)d;gastrointestinal decompression time were(5.96±1.02)and(6.84±1.31)d;length of hospital stay were(9.99±1.30)and(11.18±1.97)d;whole blood high shear viscosity were(5.22±0.25)and(5.61±0.38)mPa·s;plasma viscosity were(1.77±0.11)％and(1.84±0.17)％;platelet adhesion rates were(35.10±8.52)％and(42.55±10.01)％;CRP levels were(8.37±1.26)and(18.05±2.20)mg·L-1;TNF-α levels were(168.41±22.64)and(183.36±30.77)pg·mL-1;IL-2 levels were(28.69±4.76)and(40.08±6.74)pg·mL-1;IL-6 levels were(43.06±11.02)and(50.58±13.67)pg·mL-1;IL-8 levels were(80.13±22.66)and(94.65±26.05)pg·mL-1;sTNF-R levels were(1.12±0.14)and(1.46±0.20)ng·mL-1.The differences between the control group and the treatment group were statistically significant(all P＜0.05).Adverse drug reactions in the treatment group mainly included dizziness,nausea and vomiting,and skin allergies.Adverse drug reactions in the control group mainly included dizziness.The total incidence rates of adverse reactions in the treatment group and the control group were 7.50％and 2.50％,without statistically significant difference between the groups(P＞0.05).Conclusion The combined treatment of octreotide and ulinastatin can effectively improve hemorheology,serum inflammatory factors and sTNF-R level in patients with AP.
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