1. bookVolume 30 (2022): Issue 2 (April 2022)
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

Effects of nitroglycerin combined with continuous regional arterial infusion on severe acute pancreatitis, triglyceride, inflammatory factors and prognosis

Published Online: 09 May 2022
Volume & Issue: Volume 30 (2022) - Issue 2 (April 2022)
Page range: 191 - 198
Received: 14 Jan 2022
Accepted: 12 Apr 2022
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
Abstract

Background: To evaluate the effects of nitroglycerin combined with continuous regional arterial infusion (CRAI) on severe acute pancreatitis (SAP), triglyceride (TG), inflammatory factors and prognosis.

Methods: SAP patients were randomly divided into control and observation groups (n=169). The control group was treated with intravenous infusion of nitroglycerin once daily for 2 d, while the observation group was treated with nitroglycerin combined with CRAI for 7 d. Their hospitalization time, abdominal pain relief time, abdominal distension relief time and intestinal function recovery time were recorded. The levels of inflammatory factors, and TG were measured. Their liver and kidney functions, hemorheological indices, prognosis, and adverse reactions were evaluated.

Results: The observation group had significantly shorter hospitalization time, abdominal pain relief time, abdominal distension relief time, and intestinal function recovery time than those of the control group (P<0.05). After treatment, the levels of interleukin-6, tumor necrosis factor-alpha, endothelin, thromboxane A2 and TG significantly decreased in contrast with those before treatment in both groups, especially in the observation group (P<0.05). The hemorheological indices were significantly improved after treatment compared with those before treatment in both groups, and the observation group had better indices (P<0.05). The Acute Physiology and Chronic Health Evaluation-II score declined significantly in both groups after treatment, and the observation group had a more obvious decrease (P<0.05). During follow-up, similar incidence rates of adverse reactions were observed for both groups (P>0.05).

Conclusion: Nitroglycerin combined with CRAI is prominently effective for treating SAP, which can facilitate the health recovery and reduce the incidence of microcirculation disturbance-induced adverse events such as organ failure.

Keywords

1. Hong YP, Guo WY, Wang WX, Zhao L, Xiang MW, Mei FC, et al. 4-Phenylbutyric Acid Attenuates Pancreatic Beta-Cell Injury in Rats with Experimental Severe Acute Pancreatitis. Int J Endocrinol. 2016;2016:4592346. DOI: 10.1155/2016/459234610.1155/2016/4592346502148527656209 Search in Google Scholar

2. Stigliano S, Sternby H, de Madaria E, Capurso G, Petrov MS. Early management of acute pancreatitis: A review of the best evidence. Dig Liver Dis. 2017;49(6):585-94. DOI: 10.1016/j.dld.2017.01.16810.1016/j.dld.2017.01.16828262458 Search in Google Scholar

3. Abdel-Aziz AM, Rifaai RA, Abdel-Gaber SA. Possible mechanisms mediating the protective effect of cilostazol in L-arginine induced acute pancreatitis in rats: role of cGMP, cAMP, and HO-1. Naunyn Schmiedebergs Arch Pharmacol. 2020;393(10):1859-70. DOI: 10.1007/s00210-020-01897-z10.1007/s00210-020-01897-z32424476 Search in Google Scholar

4. Miličić D, Jakuš N, Fabijanović D. Microcirculation and heart failure. Curr Pharm Design. 2018;24(25):2954-9. DOI: 10.2174/138161282466618062514323210.2174/138161282466618062514323229938612 Search in Google Scholar

5. Hirota M, Shimosegawa T, Kitamura K, Takeda K, Takeyama Y, Mayumi T, et al. Continuous regional arterial infusion versus intravenous administration of the protease inhibitor nafamostat mesilate for predicted severe acute pancreatitis: a multicenter, randomized, open-label, phase 2 trial. J Gastroenterol. 2020;55(3):342-52. DOI: 10.1007/s00535-019-01644-z10.1007/s00535-019-01644-z702621231758329 Search in Google Scholar

6. Siregar GA, Siregar GP. Management of severe acute pancreatitis. Open Access Maced J Med Sci. 2019;7(19):3319-23. DOI: 10.3889/oamjms.2019.72010.3889/oamjms.2019.720695395031949538 Search in Google Scholar

7. Wang X, Xu J, Li J, Cheng Y, Liu L, Du Z. Effect of regional arterial infusion combined with early enteral nutrition on severe acute pancreatitis. J Int Med Res. 2019;47(12):6235-43. DOI: 10.1177/030006051988076010.1177/0300060519880760704566331662003 Search in Google Scholar

8. Fidan S, Erkut M, Cosar AM, Yogun Y, Örem A, Sönmez M, et al. Higher Thrombin-Antithrombin III Complex Levels May Indicate Severe Acute Pancreatitis. Digest Dis. 2018;36(3):244-51. DOI: 10.1159/00048561310.1159/00048561329332096 Search in Google Scholar

9. Xu C, Liu J, Li Z, Luan X. Efficacy analysis of continuous blood purification therapy for patients with severe acute pancreatitis and acute kidney injury. Panminerva Med. 2020;5(3):61-7. DOI: 10.23736/S0031-0808.20.04032-X10.23736/S0031-0808.20.04032-X32759904 Search in Google Scholar

10. Gao N, Yan C, Zhang G. Changes of serum procalcitonin (PCT), C-reactive protein (CRP), interleukin-17 (IL-17), interleukin-6 (IL-6), high mobility group protein-B1 (HMGB1) and D-dimer in patients with severe acute pancreatitis treated with continuous renal replacement therapy (CRRT) and its clinical significance. Med Sci Monit. 2018;24:5881-6. DOI: 10.12659/MSM.91009910.12659/MSM.910099611816230136704 Search in Google Scholar

11. Luo Y, Li Z, Ge P, Guo H, Li L, Zhang G, et al. Comprehensive Mechanism, Novel Markers and Multidisciplinary Treatment of Severe Acute Pancreatitis-Associated Cardiac Injury-A Narrative Review. J Inflamm Res. 2021;14:3145-69. DOI: 10.2147/JIR.S31099010.2147/JIR.S310990 Search in Google Scholar

12. Rong Y, Ren J, Song W, Xiang R, Ge Y, Lu W, et al. Resveratrol suppresses severe acute pancreatitis-induced microcirculation disturbance through targeting SIRT1-FOXO1 Axis. Oxid Med Cell Longev. 2021;2021: 8891544. DOI: 10.1155/2021/889154410.1155/2021/8891544 Search in Google Scholar

13. Yang N, Zhang DL, Hao JY. Coagulopathy and the prognostic potential of D-dimer in hyperlipidemia-induced acute pancreatitis. Hepatob Pancreat Dis Int. 2015;14(6):633-41. DOI: 10.1016/S1499-3872(15)60376-910.1016/S1499-3872(15)60376-9 Search in Google Scholar

14. Zhu Y, Pan X, Zeng H, He W, Xia L, Liu P, et al. A study on the etiology, severity, and mortality of 3260 patients with acute pancreatitis according to the revised Atlanta classification in Jiangxi, China over an 8-year period. Pancreas. 2017;46(4):504-9. DOI: 10.1097/MPA.000000000000077610.1097/MPA.000000000000077628196012 Search in Google Scholar

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