Effect of continuous renal replacement therapy adjuvant to broad-spectrum enzyme inhibitors on the efficacy and inflammatory cytokines in patients with severe acute pancreatitis

摘要

Objective: To investigate the effect of continuous renal replacement therapy (CRRT) combined with ulinastatin, a broad-spectrum enzyme inhibitor, on the treatment effect and inflammatory mediator levels in patients with severe acute pancreatitis (SAP). Methods: A total of 80 patients with SAP admitted to our hospital were divided into two groups according to a random number table, with 40 cases in the control group and 40 cases in the experimental group. The control group was treated with the broad-spectrum enzyme inhibitor ulinastatin, and the experimental group was treated with continuous renal replacement therapy (CRRT) in addition to the control group’s treatment method. The clinical efficacy was evaluated. Serum inflammation indicators, critical illness-related scores, pancreatic microcirculation and coagulation indicators were also detected before and after treatment. Results: After 14 days of continuous intervention, the total effective rate of the experimental group was 92.50%, and that of the control group was 75.00%, with statistical significance between the two groups (P0.05). The expression of APN in the two groups’ serum increased, and the other inflammatory indexes decreased. The experimental group’s serum APN was higher than that of the control group, and the other inflammatory indexes were lower than those of the control group (all P0.001). The two groups’ critical illness-related scores were improved, and there was a difference between the two groups (P0.05). The levels of BF and BV increased, while TTP levels decreased, and there was a difference between the experimental and control groups (all P0.01). The coagulation indexes of the two groups of patients were all improved. Compared with the control group, the coagulation indexes of the experimental group were lower. There was a difference between the two groups (P0.01). Conclusion: CRRT adjuvant to broad-spectrum enzyme inhibitor ulinastatin can significantly improve the inflammatory response, microcirculation, hypercoagulability and clinical treatment efficacy in patients with severe acute pancreatitis.