Clinical effect of glutamine combined with early enteral nutrition on systemic inflammation in critically ill patients with acute pancreatitis

Abstract

Objective To investigate the effect of glutamine combined with early enteral nutrition on the inflammatory response in patients with severe pancreatitis. Methods From June 2014 to April 2016, 82 patients with severe acute pancreatitis admitted in our hospital were divided into observation group and control group according to the different treatment regimen. The patients in the control group underwent parenteral nutrition only, while the patients in the observation group underwent early enteral nutrition combined with glutamine. The inflammatory response, amino acid metabolism of the two groups were observed and analyzed. Results After treatment, the levels of MCP-1 [(25.3±3.4)ng/ml], HMGB-1 [(6.7±0.9)ng/ml] in the observation group were significantly lower than those in the control group [(41.2±6.3)ng/ml,(10.5±1.7)ng/ml], with statistically significant differences (P<0.05). After treatment, the levels of serum threonine [(11.2±1.5)μmol/L], phenylalanine [(4.3±0.6)μmol/L], valine [(4.9±0.7)μmol/L], and lysine [(6.6±0.8)μmol/L] in the observation group were significantly higher than those in the control group [(7.6±0.9)μmol/L, (2.3±0.4)μmol/L, (3.5±0.4)μmol/L, (2.7±0.3)μmol/L], with statistically significant differences (P<0.05). Conclusion Early enteral nutrition combined with glutamine in the treatment of critical pancreatitis, can effectively promote the improvement of protein synthesis in patients, helps to alleviate the body negative nitrogen balance and systemic inflammatory response, which is recommended in clinical application. Key words: Critical pancreatitis; Enteral nutrition; Glutamine; Inflammatory response