title: Effect of Somatostatin, Ulinastatin and Gabexate on the Treatment of Severe Acute Pancreatitis.
abstract: OBJECTIVE
  The objective of this study is to evaluate the efficacy of somatostatin, ulinastatin and gabexate for the treatment of severe acute pancreatitis.
  
  
  METHODS
  A total of 492 patients with severe acute pancreatitis were assigned randomly into the following 4 groups: (1) somatostatin; (2) somatostatin + ulinastatin; (3) somatostatin + gabexate and (4) somatostatin + ulinastatin + gabexate. Acute physiology and chronic health evaluation II scores; clinical parameters including time of abdominal pain and distention extinct; recovering to normality of heart rate and respiration rate; amylase and blood glucose; ratios of efficacy; multiple organ dysfunction syndrome (MODS); mortality; complication; levels of endotoxin; tumor necrosis factor alpha; interleukin-6 (IL-6), IL-8 and IL-10 and side effects were analyzed.
  
  
  RESULTS
  Acute physiology and chronic health evaluation II scores, time of abdominal pain extinct and distention extinct, time of recovering to normality of heart rate, time of recovering to normality of respiration rate and time of recovering to normality of amylase and blood glucose were significantly decreased in the somatostatin + ulinastatin, the somatostatin + gabexate and the somatostatin + ulinastatin + gabexate subgroups compared with the somatostatin subgroup. Ratios of efficacy were significantly improved, whereas ratios of MODS, mortality and complication were significantly decreased in the somatostatin + ulinastatin and the somatostatin + ulinastatin + gabexate subgroups compared with the somatostatin subgroup. Tumor necrosis factor alpha, IL-6 and IL-8 levels on the fourth day after treatment showed significant decrease in the somatostatin + ulinastatin, the somatostatin + gabexate and the somatostatin + ulinastatin + gabexate subgroups compared with the somatostatin subgroup. The IL-10 levels on the fourth day were significantly improved in the somatostatin + ulinastatin, the somatostatin + gabexate and the somatostatin + ulinastatin + gabexate subgroups compared with the somatostatin subgroup.
  
  
  CONCLUSIONS
  Somatostatin is effective for the treatment of acute pancreatitis, ulinastatin demonstrates improvement in therapeutic benefits and gabexate can relieve the clinical symptoms and shorten the course of disease but cannot improve the effective ratio or decrease MODS, mortality and complication.
authors.affiliation: Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, Pingxiang, PR China; Department of Digestive Internal Medicine, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, PR China.
authors.forename: Guiliang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Digestive Internal Medicine, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, Florida.
authors.forename: Shu-Feng
authors.initials: SF
authors.lastname: Zhou
authors.affiliation: Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, Pingxiang, PR China.
authors.forename: Ping
authors.initials: P
authors.lastname: Qiu
authors.affiliation: Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, Pingxiang, PR China.
authors.forename: Linfang
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, Pingxiang, PR China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wen
authors.affiliation: Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, Pingxiang, PR China.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Wen
authors.affiliation: Laboratory of Shock, Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, PR China. Electronic address: csxianzhongxiao@126.com.
authors.forename: Xianzhong
authors.initials: X
authors.lastname: Xiao
mesh_terms: D000208:Acute Disease; D000328:Adult; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D016670:Gabexate / Q000627:therapeutic use*; D006023:Glycoproteins / Q000627:therapeutic use*; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D013004:Somatostatin / Q000627:therapeutic use*; D014361:Trypsin Inhibitors / Q000627:therapeutic use*
chemical_list: D006023:Glycoproteins; D006728:Hormones; D015842:Serine Proteinase Inhibitors; D014361:Trypsin Inhibitors; D016670:Gabexate; D013004:Somatostatin; C028665:urinastatin
keywords: Cytokine; Gabexate; Severe acute pancreatitis; Somatostatin; Ulinastatin