Clinical effect of somatostatin combined with alprostadil for patients with severe acute pancreatitis and its effect on the serum inflammatory factors

Abstract

Objective To observe the clinical effect of somatostatin combined with alprostadil in the treatment of severe acute pancreatitis and its influence on serum inflammatory factors. Methods Seventy-three patients with severe acute pancreatitis were enrolled in this study from May 2015 to May 2017 in Department of Hepatobiliary Surgery of Third People′s Hospital of Yunnan Province.These patients were randomly divided into observation group and control group according to the random number table method.The patients in control group were treated with routine treatment combined with somatostatin, and the patients in observation group were treated with routine treatment combined with somatostatin and alprostadil for 2 weeks.The clinical efficacy, symptom remission time, serum inflammatory factor level, adverse reaction rate and mortality rate of the two groups were observed. Results The total effective rate was 87.5%(28/32)in observation group and 75.6%(31/41)in control group, and the difference was statistically significant(P<0.05). The recovery time of bowel pain, recovery time of intestinal function, recovery time of blood amylase(AMY)and the average hospitalization time of observation group were shorter than those of control group [(3.2±1.2)d vs.(4.9±1.1)d, (3.7±1.1)d vs.(5.4±1.4)d, (5.8±1.1)d vs.(7.5±1.3)d, (14.8±5.2)d vs.(18.6±4.6)d], and the differences were statistically significant(P<0.05). The levels of acute physiology and chronic health evaluationⅡ(APACHEⅡ), white blood count(WBC), C-reactive protein(CRP), AMY, alanine aminotransferase(ALT)and serum creatinine(Cr)in the two groups after treatment declined significantly.The levels of APACHEⅡ, WBC, CRP, AMY, ALT and Cr in observation group were lower than those in control group at 7 days and 14 days after treatment [(9.2±2.2) vs.(10.5±1.5), (12.2±3.2)×109/L vs.(13.9±2.9)×109/L, (72.3±17.3)mg/L vs.(106.5±20.1)mg/L, (389.6±57.6)U/L vs.(1 066.3±152.4)U/L, (62.9±8.8)U/L vs.(80.4±11.5)U/L, (82.5±18.6)μmol/L vs.(108.6±20.5)μmol/L; (6.8±2.0) vs.(8.3±2.4), (7.5±1.2)×109/L vs.(8.6±1.4)×109/L, (24.2±8.6)mg/L vs.(52.7±15.2)mg/L, (72.6±15.2)U/L vs.(138.2±25.6)U/L, (22.5±6.4)U/L vs.(42.6±12.8)U/L, (46.2±10.4)μmol/L vs.(70.1±16.2)μmol/L], and the differences were statistically significant(P<0.05). The levels of endotoxin, tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the two groups declined significantly after treatment.The levels of endotoxin, TNF-αand IL-6 in observation group were lower than those in control group [(45.3±9.8)Eu/ml vs.(53.2±10.3)Eu/ml, (62.5±13.7)ng/L vs.(76.3±14.2)ng/L, (60.3±11.4)ng/L vs.(81.2±20.9)ng/L], and the differences were statistically significant(P<0.05). The mortality rate was 12.5%(4/32)in observation group and 25.4%(10/41)in control group, and the difference was statistically significant(P<0.05). Conclusion The effect of somatostatin combined with alprostadil in the treatment of severe acute pancreatitis is obvious, and this treatment can reduce effectively the levels of serum inflammatory factors, which is worthy to be popularized. Key words: Severe acute pancreatitis; Alprostadil; Somatostatin; Interleukin-6