Clinical evaluation of different doses of somatostatin combined with omeprazole for pediatric acute pancreatitis

Yao Dandan; Zhao Chengpeng; Duan Yongfu; Wang Guantao; Liu Xinxin

doi:10.3969/j.issn.1672-8157.2025.05.036

Abstract：Objective To investigate the efficacy of different doses of somatostatin combined with omeprazole in the treat-ment of pediatric acute pancreatitis and its impact on serum amylase,erythrocyte sedimentation rate and inflammatory factors.Methods A total of 80 children with acute pancreatitis admitted to Nanyang Central Hospital from November 2020 to August 2024 were selected and divided into the standard-dose group and the doubled-dose group by using the random number table method,with 40 in each group.Omeprazole was injected intravenously in both groups.On this basis,3.5 μg·kg﹣1·h﹣1 and 7 μg·kg﹣1·h﹣1 growth inhib-itor was pumped intravenously in the standard-dose group and the double-dose group,respectively.The treatment was continued for 24 h,once a day,for 7 d in both groups.The clinical efficacy,clinical indexes,inflammatory indexes,enzymatic indexes,coagulation indices,modified computed tomography severity index score and health status before and after treatment were compared between the two groups.Results The therapeutic efficiency of the doubled-dose group was 92.50%,which was significantly higher than that of the standard-dose group(75.00%),and the difference was statistically significant(χ2=4.501,P=0.034).The abdominal pain relief,nausea and vomiting disappearance time,and hospitalization time of the children in the doubled-dose group were(3.29±1.03)d,(4.09±1.26)d,and(10.71±2.58)d,respectively,which were shorter than those of the standard-dose group(4.62±1.18)d,(5.11±1.34)d,and(12.86±3.03)d,and the differences were statistically significant(t=5.370,P<0.001;t=3.507,P<0.001;t=3.417,P=0.001).After treatment,the levels of inflammatory factors interleukin-6,tumor necrosis factor-α,C-reactive protein and erythrocyte sedimentation rate in the standard-dose and in the doubled-dose group((77.85±18.62)pg·mL﹣1,(196.53±31.08)pg·mL﹣1,(20.36±4.55)mg·mL﹣1,(43.16±11.02)mm·h﹣1,(60.91±17.40)pg·mL﹣1,(173.62±30.79)pg·mL﹣1,(12.94±2.82)mg·mL﹣1,(35.77±9.29)mm·h﹣1)were lower than those before treatment((131.28±30.17)pg·mL﹣1,(408.44±65.72)pg·mL﹣1,(161.84±23.03)mg·L﹣1,(106.94±24.56)mm·h﹣1,(127.59±29.42)pg·mL﹣1,(411.25±67.70)pg·mL﹣1,(159.43±22.50)mg·L﹣1,(107.59±24.87)mm·h﹣1),and the they were lower in the doubled-dose group than in the standard-dose group(t=4.204,P<0.001;t=3.312,P=0.001;t=8.767,P<0.001;t=3.243,P=0.002).The levels of serum amylase,lipase,and urinary amylase in the standard-dose and in the doubled-dose group((237.88±26.14)U·L﹣1,(271.16±23.59)U·L﹣1,(1 617.38±246.99)U·L﹣1,(204.57±22.30)U·L﹣1,(221.74±20.68)U·L﹣1,and(1 432.22±238.71)U·L﹣1)were lower than those before treatment((331.84±32.21)U·L﹣1,(557.66±45.83)U·L﹣1,(2 111.26±384.15)U·L﹣1,(329.46±31.59)U·L﹣1,(563.74±46.45)U·L﹣1,(2 016.33±373.27)U·L﹣1),and they were remarkably lower in the doubled-dose group than in the stan-dard-dose group(t=6.131,P<0.001;t=9.963,P<0.001;t=3.409,P=0.001).The prothrombin time,activated partial thromboplastin time and the level of D-dimer in the standard-dose and in the doubled-dose group after treatment((12.39±1.86)s,(32.64±4.15)s,and(1.48±0.36)μg·mL﹣1,(11.20±1.82)s,(27.57±4.12)s,and(0.71±0.12)μg·mL﹣1)were lower than those before treatment((13.59±2.24)s,(35.49±4.28)s,(2.41±0.63)μg·mL﹣1,(13.87±2.33)s,(35.65±4.33)s,(2.35±0.61)μg·mL﹣1),and the they were significantly lower in the doubled-dose group than in the standard-dose group(t=2.892,P=0.005;t=5.483,P<0.001;t=12.833,P<0.001).After treatment,the scores of modified computed tomography severity index and acute physiology and chronic health evaluation in the standard-dose and in the doubled-dose group((4.57±1.12)points,(14.22±1.88)points,(3.02±0.85)points,(11.03±1.27)points)were lower than those before treatment((8.13±1.46)points,(21.49±2.17)points,(8.02±1.44)points,(20.78±2.16)points),and they were lower in the doubled-dose group than in the standard-dose group(t=6.972,P<0.001;t=8.893,P<0.001).The incidence of adverse reactions was 7.50%in the double-dose group and 2.50%in the standard-dose group,showing no statistically significant difference(χ2=1.053,P=0.615).Conclusion The effect of 7 μg·kg﹣1·h﹣1 of somatostatin combined with omeprazole on pediatric acute pancreatitis in children is significant since it can accelerate the improvement of symptoms,improve the hypercoagulable state of the blood,reduce the inflammatory response,lower the level of inflammatory factors and erythrocyte sedimentation rate,and promote the restoration of the normal level of serum amylase and other enzymes.