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Original Research Article | OPEN ACCESS

Effect of low molecular weight heparin and ulinastatin as a combined therapy on soluble myeloid cell expression and intestinal mucosal function in patients with severe pancreatitis

Dong Qian , Xinyuan Luan, Yanan Zhang

The Third Department of Hepatobiliary and Pancreatic Diseases, Nankai Hospital, Tianjin 300100, China;

For correspondence:-  Dong Qian   Email: NKYYLXY@163.com

Accepted: 7 June 2022        Published: 31 July 2022

Citation: Qian D, Luan X, Zhang Y. Effect of low molecular weight heparin and ulinastatin as a combined therapy on soluble myeloid cell expression and intestinal mucosal function in patients with severe pancreatitis. Trop J Pharm Res 2022; 21(7):1515-1521 doi: 10.4314/tjpr.v21i7.23

© 2022 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To investigate the effect of low molecular weight heparins (LMWHs) and ulinastatin on soluble myeloid cells and intestinal mucosal function (IMF) in patients with severe pancreatitis.
Methods: A total of 107 patients with severe pancreatitis were divided into two groups: control group (CG, n = 53) and study group (SG, n = 54). The CG was treated with LMWH while SG was similarly treated but in addition received ulinastatin simultaneously. The following parameters were evaluated in the two groups: treatment effects, IMF, time for various indicators to normalize, vascular endothelial function, complication symptoms, T lymphoid subgroup indicators, inflammatory factors, anti-inflammatory factors, soluble B7-H2, and soluble myeloid cell receptor-1 level changes.
Results: After treatment, SG showed lower levels of L/M value, DAO and D-lactic acid than in CG (p < 0.05). Gastrointestinal function, leukocytes, amylase, and body temperature in SG had a shorter time to return to normal than in CG (p < 0.05). The levels of IL-10 in SG were higher than in CG, while sB7-H2, TNF-α, sTREM-1 and IL-1 levels were lower than those in the CG (p < 0.05). After treatment, NO levels in SG were higher, but TXB2, vWF and ET levels were lower than in CG (p < 0.05). In addition, CD4+, CD4+/CD8+ indicators were higher and CD8+ lower in SG than in CG (p < 0.05).
Conclusion: Ulinastatin + LMWHs improves IMF in patients suffering from severe pancreatitis, shortens the time for various indicators to normalize, and reduces incidence of complications. However, further clinical trials are required to ascertain this therapeutic strategy for the management of severe pancreatitis.

Keywords: Low molecular weight heparin, Ulinastatin, Severe pancreatitis, Soluble myeloid cell expression, Intestinal mucosal function, Treatment effect

Impact Factor
Thompson Reuters (ISI): 0.523 (2021)
H-5 index (Google Scholar): 39 (2021)

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