Abstract
Objective To explore the therapeutic effect of immune regulating nutrition on severe acute pancreatitis (SAP). Methods The clinical data of 80 patients with SAP who were admitted to the Union Hospital of Huazhong University of Science and Technology from February 2008 to October 2009 were prospectively analyzed. The 80 patients were equally divided into conventional nutrition (CN) group and immune regulating nutrition (IRN) group. Patients in the CN group received CN support, while patients in the IRN group were supplemented with ω-3 polyunsaturated fatty acid (ω-3 PUFA ) and glutamine at the basis of CN support.APACHE Ⅱ scores were evaluated at day 1, 4, 7, 10, 14 in the course of treatment. The differences in the incidence of pulmonary and abdominal infection, sepsis, and other clinical parameters including operation intervention, mortality, length of ICU and hospital stay between the two groups were compared. All data were analyzed using the t test and chi-square test. Results The APACHE Ⅱ scores of patients in the IRN group were 15.3 ± 1.8 and 9.0 ± 1.8 at day 4 and 7, which were significantly lower than 20.0 ± 2.7 and 13.3 ± 2.4 in the CN group, respectively (t = 3.3, 2. 8, P 0.05). The incidences of pulmonary and abdominal infection and surgical intervention rate in the IRN group were 18% (7/40), 13% (5/40) and 5% (2/40), which were significantly lower than 38% (15/40), 33% (13/40)and 20% (8/40) in the CN group, respectively (χ2 =4.0, 4.6, 4.1, P 0.05 ). The average lengths of ICU and hospital stay in the IRN group were (5.4 ± 1.6 ) days and ( 38.6 ± 9.3 ) days, which were significantly lower than ( 7.8 ± 2.8 ) days and (43.1 ± 1 1.6) days in the CN group, respectively ( t = 2. 7, 3. 7, P 0.05). Conclusion CN support supplemented with ω-3 PUFA and glutamine can adjust the inflammation reaction of SAP and sustain the normal immune function, which is helpful in decreasing the incidence of severe infection. Key words: Severe acute pancreatitis; Immune regulation; Nutrition; Unsaturated fatty acid; Glutamine
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