Observation on the therapeutic effects of somatostatin injected in different rates on the fat-derived severe acute pancreatitis during hemoperfusion

Abstract

Objective To observe the therapeutic effects of somatostatin administered in different speeds on the severe acute pancreatitis during hemoperfusion. Methods A total of 112 severe acute pancreatitis patients with routine treatment in emergency intensive care unit were divided into control group and experimental group according to the speed of somatostatin injection during hemoperfusion. Patients of experimental group (n=56) received accelerated injection of somatostatin, while the patients of control group (n=56) got somatostatin in a steady speed injection. The time required for relieving clinical symptoms, time consumed for resuming normal results of laboratory tests, changes of inflammatory mediators, morbidity and mortality rate were compared between two groups. Results The levels of serum C-reactive protein, tumor necrosis factor-α and interleukin-6 in experimental group were significantly decreased from (35.3±13.1)mg/L, (149.3±26.4)ng/L, (131.9±19.3)ng/L to (12.8±4.4)mg/L, (88.4±19.4)ng/L, (66.0±17.4)ng/L, respectively compared to those of control group (P<0.05). There were shortened hospital stay (18.2±4.1)d, and reduced the time required for relief of abdominal pain and distention (6.4±1.9)d, (8.8±3.3)d, and for normalized WBC and amylase (7.1±1.20)d, (9.5±2.0)d found after accelerated injection of somatostatin in experimental group compared with control group (20.5±5.4)d, (7.7±2.5)d, (11.2±4.1)d, (8.1±3.3)d, (10.8±2.9) d, (P<0.05). Compared with control group(8.8±2.2), the Acute Physiology and Chronic Health Evaluation (APACHE)Ⅱ scores after treatment for one week were significantly lower in the experimental group(7.5±2.3)( P<0.05). The incidence of morbidity in experimental group was significantly lower than that in control group (P<0.05). Additionally, OR value for morbidity was 0.429, and OR value for death was 0.65. Conclusions The accelerated injection of somatostatin during hemoperfusion could obviously improve the therapeutic effect and decrease the serum inflammatory mediators in severe acute pancreatitis, as well as reduce the incidence of morbidity and mortality. Key words: Severe Acute Pancreatitis; Somatostatin; Hemoperfusion; Inflammatory mediators; C reactive protein; APACHEⅡ scores; Interleukin-6; Tumor necrosis factor α