The Efficacy Of Different Doses Of Ulinastatin In The Treatment Of Severe Acute Pancreatitis

Objective: To study the effects of different doses of ulinastatin(UTI)on patients with severe acute pancreatitis(SAP),determine whether there is a quantitative effect relationship between SAP and ulinastatin.Methods:From January 2013 to May 2018,A retrospective study was conducted examining the clinical outcomes of 130 SAP patients.Those patients were from the Emergency Department and the Emergency ICU of the First Affiliated Hospital of Anhui Medical University.Patients were categorized into a control group and three groups receiving different daily doses of UTI(200,000 IU;400,000 IU;600,000 IU).The study compared the 1-week mortality rate,the Acute Physiology and Chronic Health Evaluation(APACHE)score,abdominal pain relief time,time of recovery to a normal heart and respiratory rate,blood amylase level,blood glucose level,C-reactive protein(CRP),procalcitonin(PCT)and white blood cell(WBC)counts among the different groups.To understand whether different doses of ulinastatin have different efficacy in SAP patients.Results: The 400,000 IU group and the 600,000 IU group had significantly lower mortality rates compared to the 200,000 IU group(p<0.05),besides,the 400,000 IU group had a lower mortality rates compared to the control group(p<0.05).The 200,000 IU group,400,000 IU group and 600,000 IU group had a higher difference in APACHE-? score compared to the control group at admission and after treatment for 1 week(p<0.05),the 600,000 IU group had a higher difference in APACHE-?score compared to the 200,000 IU group at admission and after treatment for 1 week(p<0.05).Furthermore,In terms of abdominal pain relief time,heart rate and respiratory recovery normal time were the 400,000 IU group and the 600,000 IU group shorter than the control group(p<0.05).Compared to the 200,000 IU group,the 600,000 IU group had a significantly shorter time of recovery to a normal respiratory rate(p<0.05).The 400,000 IU group had a significantly shorter abdominal pain relief time compared to the 200,000 IU group(p<0.05).There was no significant difference in blood amylase and PCT between the four groups(p>0.05).In terms of blood glucose and CRP levels,the 200,000 IU group,400,000 IU group and 600,000 IU were higher than the control group at admission and after treatment for 1 week(p<0.05).The 400,000 IU group and the 600,000 IU group had significantly higher WBC counts compared to the control group and the 200,000 IU group(p<0.05).Conclusion:(1)Ulinastatin can improve the clinical outcomes of patients with SAP.(2)Different doses of ulinastatin have different effects on SAP,Increase the dose of ulinastatin can improve the efficacy of SAP patients.