Effect of intensified insulin therapy on intestinal mucosal function and prognosis of patients with acute pancreatitis

Li Yupeng; Liu Bin; Xing Chengwen; Hou Ming

doi:10.3760/j.issn.1673-4777.2018.05.020

Abstract：Objective To explore the effect of intensified insulin therapy on intestinal mucosal function and prognosis of patients with acute pancreatitis.Methods Fifty patients with acute pancreatitis in Qinghai Renji Hospital from January 2013 to January 2017 were randomly divided into observation group and control group,with 25 cases in each group.The control group had conventional medical treatment;the observation group had intensified insulin therapy on the basis of control group.Levels of inflammatory factors,D-lactate and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were analyzed.Results Levels of C-reactive protein,interleukin-8,tumor necrosis factor-ct after treatment were significantly lower than those before treatment in both groups [observation group:(50 ± 15) mg/L vs (170 ± 33) mg/L,(33.2 ± 2.7) ng/L vs (100.3 ± 16.0) ng/L,(17 ±5)ng/L vs (61 ± 17) ng/L;control group:(80 ± 18)mg/L vs (170 ±31) mg/L,(51.6 ±8.6) ng,/L vs (100.3 ± 15.9) ng/L,(29 ± 6) ng/L vs (61 ± 18) ng/L];level of D-lactate after treatment was significantly lower than that before treatment in observation group [(1.02 ± 0.16) kU/L vs (1.62 ± 0.43) kU/L];levels of C-reactive protein,interleukin-8,tumor necrosis factor-α and D-lactate after treatment in observation were significantly lower than those in control group(P ＜ 0.05).The APACHE Ⅱ score after treatment was significantly lower than that before treatment in both groups [observation group:(9.6 ± 2.4) points vs (26.2 ± 3.1) points;control group:(14.6 ±3.1)points vs (26.2 ±3.1)points];the APACHE score after treatment in observation was significantly lower than that in control group(P ＜0.05).Fatality rate of patients had no significant difference between groups (P ＞0.05).Conclusion Intensified insulin therapy treating acute pancreatitis can significantly reduce inflammatory reaction,protect intestinal mucosal function and improve the prognosis.