The Treatment Of Low-dose Glucocorticoid To Severe Acute Pancreatitis: An Clinical Observation

Objective To evaluate the effects of low dose glucocorticoid on severe acute pancreatitis(SAP) and further to discuss the mechanism of this therapeutic method.Methods Thirty-nine patients with SAP hospitalized in Department of Intensive Unit Care from july 2010 to march 2011 were enrolled this experiment,all of the patients were in hospital within 5 days after ill and accorded with the diagnostic criteria of SAP pressed by Chinese Medical Association in 2004.Thirty-nine patients were randomly divided into low-dose methylprednisolone treatment group with 19 cases and routine treatment group with 20 cases. Observed the effects of low-dose glucocorticoid on SAP, including the systemic inflammatory response syndrome (SIRS), plasma inflammatory mediators, ICU length of stay, APACHEⅡand the 28-day mortality.Results The severity of SAP patients has no significant difference before treatment verified by APACHEⅡscore.APACHEⅡscore in low-dose methylprednisolone treatment group significantly decreased compared with routine treatment group on the fifth day;the application of low-dose methylprednisolone can significantly reduce plasma inflammatory mediators (TNF-α, IL-6, CRP); systemic inflammatory response syndrome score started to decrease on the third day of using low-dose methylprednisolone,but 28 day mortality was no conspicuous difference between the two groups.Conclusion The application of low-dose glucocorticoid to SAP can decrease the systemic inflammatory mediators concentrations in plasma,lighten the systemic inflammatory response syndrome, and lower the APACHEII score; but has no the function to down the 28 day mortality.