Impact of alanyl-glutamine dipeptide on severe acute pancreatitis in early stage.
OBJECTIVE
To evaluate the therapeutic effect of alanyl-glutamine dipeptide (AGD) in the treatment of severe acute pancreatitis (SAP) in early and advanced stage.


METHODS
Eighty patients with SAP were randomized and received 100 mL/d of 20% AGD intravenously for 10 d starting either on the day of (early treatment group) or 5 d after (late treatment group) admission. Groups had similar demographics, underlying diseases, Ranson score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Balthazar's computed tomography (CT) score at the beginning of the study and underwent similar other medical and nutritional management.


RESULTS
The duration of acute respiratory distress syndrome (2.7 +/- 3.3 d vs 12.7 +/- 21.0 d, P < 0.01), renal failure (1.3 +/- 0.5 d vs 5.3 +/- 7.3 d, P < 0.01), acute hepatitis (3.2 +/- 2.3 d vs 7.0 +/- 7.1 d, P < 0.01), shock (1.7 +/- 0.4 d vs 4.8 +/- 3.1 d, P < 0.05), encephalopathy (2.3 +/- 1.9 d vs 9.5 +/- 11.0 d, P < 0.01) and enteroparalysis (2.2 +/- 1.4 d vs 3.5 +/- 2.2 d, P < 0.01) and hospital stay (28.8 +/- 9.4 d vs 45.2 +/- 27.1 d, P < 0.01) were shorter in the early treatment group than in the late treatment group. The 15-d APACHE II score was lower in the early treatment group than in the late treatment group (5.0 +/- 2.4 vs 8.6 +/- 3.6, P < 0.01). The infection rate (7.9% vs 26.3%, P < 0.05), operation rate (13.2% vs 34.2%, P < 0.05) and mortality (5.3% vs 21.1%, P < 0.05) in the early treatment group were lower than in the late treatment group.


CONCLUSIONS
Early treatment with AGD achieved a better clinical outcome in SAP patients.
Xue
Ping
P
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Deng
Li-Hui
LH
Xia
Qing
Q
Zhang
Zhao-Da
ZD
Hu
Wei-Ming
WM
Yang
Xiao-Nan
XN
Song
Bing
B
Huang
Zong-Wen
ZW
D000328:Adult; D000368:Aged; D004151:Dipeptides / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis
D004151:Dipeptides; C054122:alanylglutamine