| Objective:To investigate the effect of ulinastatin combined with glutamine on the immune function and prognosis of patients with severe acute pancreatitis(SAP).Methods:63 severe acute pancreatitis patients admitted to the emergency surgery department of our hospital from September 2017 to September 2018 who met the inclusion and exclusion criteria were selected.According to different treatment,patients were randomly divided into observation group and control group.There were 36 patients in the observation group and 27 patients in the control group.Patients in the control group were treated with SAP routine treatment:fasting water,preventing infection,inhibiting acid and enzyme,supplementing fluid,supporting organ function,etc.The observation group was treated with ulinastatin and glutamine on admission on the basis of routine treatment,with intravenous infusion of ulinastatin 100,000 units/2 times/day,and oral administration of glutamine capsules 0.5g/3 times/day.On the first,fourth and seventh day of treatment,all SAP patients were sampled from the fasting peripheral venous blood transfusion laboratory to test T cell subgroup level,c-reactive protein concentration,neutrophil count.and the changes of these indicators within one week after admission were dynamically recorded.Statistical methods were used to compare and analyze the changes of various indicators in the two groups of patients,and to compare the clinical symptoms and prognosis of the two groups of patients.SPSS 19.0 statistical software was used to process all the data.The measurement data were compared by t test.The counting data were compared by chi-square test..P<0.05 was statistically significant.Results:1.On admission,the level of T lymphocyte subsets was decreased,neutrophil count and c-reactive protein concentration were increased in the two groups of patients.Before treatment,there were no statistically significant differences in T lymphocyte subgroup level,c-reactive protein concentration and neutrophil count between the two groups(P>0.05).2.CD3+,CD4+and CD8+ were on the rise after treatme.CD3+cell level was significantly differ rent between the two groups on the 4th day(52.52±10.32%in the control group and 59.33±9.54%in the observation group)(P<0.05),and the difference between the two groups was more significant on the 7th day.CD8+ cell level was significantly different between the two groups on the 4th day(21.19±6.05%in the control group and 26.14±6.97%in the observation group)(P<0.05),and the difference between the two groups was more significant on the 7th day.On the 7th day,there was a statistically significant difference in CD4+cell level between the two groups(42.89±8.50 in the control group and 47.47±7.73 in the observation group)(P<0.05).The serum CD4+/CD8+was significantly lower in the observation group than in the control group(1.47±0.36 in the control group and 1.22±0.28 in the observation group)on the seventh day(P<0.05).The number of neutrophils showed a decreasing trend,which was(12.99±3.56)×1012/L in the control group on the fourth day and(11.13±3.52)×1012/L in the observation group.The difference between the two groups was statistically significant(P<0.05),and the difference was more significant on the seventh day.On the fourth day,the concentration of c-reaction was 124.68±69.11 mg/L in the control group and 86.81±45.40 mg/L in the observation group.The difference between the two groups was statistically significant(P<0.05).3.Compared with the clinical symptoms of patients in the two groups,the recovery time of intestinal function and the duration of SIRS in the observation group were shorter than those in the control group,and the length of hospital stay was also significantly shorter than those in the control group.The incidence and mortality of patients requiring ICU treatment in the control group were significantly higher than those in the observation group,and the difference was statistically significant(P<0.05).Conclusion:Ulinastatin combined with glutamine therapy can enhance the immune function of patients,improve the treatment effect of SAP patients and improve the survival rate. |
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