Effects of somatostatin on the clinical efficacy of elderly patients with severe acute pancreatitis

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Objective To investigate the effect of somatostatin on the clinical curative effect, prognosis and the level of inflammatory cytokines in senile severe acute pancreatitis (SAP). Methods From January 2011 to December 2015, a total of ninety elderly patients with severe acute pancreatitis in Liuzhou Railway Central Hospital of the Guangxi Zhuang Autonomous Region were enrolled in the study.The patients were randomly divided into the observation group (45 cases) and control group (45 cases), the two groups were given routine symptomatic treatment, at the same time, the control group was given omeprazole intravenous drip treatment.While on the basis of the control group, the patients in the observation group were treated with continuous intravenous infusion of somatostatin within 24 h after admission, 7 d as a course.The clinical effect of two groups of patients was compared, and serum amylase level was measured during the treatment of two groups, and the levels of serum inflammatory factors were compared between the two groups before and after treatment. Results The total effective rate was 100% (45/45)in the observation group and 80.00% (36/45)in the control group (χ2=10.000, P=0.002), while the incidence of elevated abdominal pressure, MODS and high amylase in the observation group were lower than those in the control group(2.22%(1/45)vs.17.78%(8/45); 0 vs.13.33%(6/45); 2.22%(1/45) vs.17.78%(8/45)). The differences were statistically significant (χ2=6.049, 2, 6.429, 6.049, P=0.014, 0.011, 0.014), and the rates of drug adverse reactions in the two groups were 20% (9/45) and 15.56 (7/45)%), the difference was not statistically significant (x 2=0.304, P=0.581). Abdominal pain relief time, gastrointestinal function recovery time, serum amylase returned to normal time, ventilator weaning time and the average length of hospitation in the observation group were shorter than those in the control group((1.85±0.48) d vs.(3.79±0.86)d; (2.78±0.72)d vs.(4.56±0.96)d; (2.10±0.62)d vs.(4.69±1.02)d; (3.25±0.82) d vs.(5.82±0.62)d; (7.82±1.10) d vs.(10.22±1.25)d)(t=13.502, 10.290, 14.919, 17.839, 10.076, P<0.001). High-sensitivity C reactive protein(hs-CRP)and interleukin-8 after treatment in the observation group were significantly lower than those in the control group((12.25±3.26) mg/L vs.(26.78±4.33) mg/L; (4.52±0.85) ng/L vs.(7.89±1.36) ng/L)(t=21.446, 16.810, P<0.001). Conclusion Somatostatin can effectively decrease the levels of inflammatory cytokines in SAP patients, improve the therapeutic effect of SAP patients and reduce the occurrence of related complications, which is helpful to promote the prognosis of patients with SAP. Key words: Somatostatin; Elderly; Severe acute pancreatitis; Clinical efficacy; Inflammatory factor