Authors

Xueying Cai]* Kaiyang Wang**, Jianrong Wang*, Yongke Zheng***, Wei Hu*, #

Departments

*Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China - **Department of Emergency, Second Affiliated Hospital of Nanchang University, Nanchang, PR China - ***Hangzhou Geriatric Hospital, Hangzhou, PR China

Abstract

Objective: To analyse the effect of low molecular weight heparin calcium combined with insulin in patients with high triglyceride acute pancreatitis on immune function [CD3, CD4, CD8, CD4/CD8], inflammatory response [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-8 (IL-8), tumour necrosis factor α (TNF-α)], haemorheology [platelet adhesion rate, plasma specific viscosity, high-cut whole blood specific viscosity, thrombus length] and coagulation function [FIB (fibrinogen), PLT (platelet count), PT (prothrombin time) and APPT (active partial thromboplastin time)]. 

Methods: A retrospective analysis of 80 patients with high triglyceride acute pancreatitis admitted to our Department of Gastroenterology from December 2015 to December 2018 was conducted. Patients were divided into a control group (n=40) and an observation group (n=40) according to different treatment methods. The control group was treated with low molecular weight heparin calcium plus conventional therapy, and the observation group was treated with insulin based on the control group. Both groups were treated for 5 days. The clinical efficacy, adverse reactions, immune function, inflammatory response, haemorheology and coagulation function levels of the two groups were compared. 

Results: The total effective rate in the observation group was 93.5% and 75.00% in the control group. The difference in the total effective rate between the two groups was statistically significant (P<0.05). After treatment, the level of CD3, CD4, CD8 and CD4/CD8 in the observation group was significantly higher than before treatment, and the CD3, CD4, CD8 and CD4/CD8 in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the levels of IL-6, IL-8, TNF-α and CRP were significantly decreased. The levels in the observation group were lower than those in the control group (P<0.05); the platelet adhesion rate, plasma specific viscosity, high-cut whole blood specific viscosity and thrombus length were clearly decreased, and the levels in the observation group were lower than in the control group (P<0.05). The levels of FIB, PT and APPT in the two groups were significantly decreased. The observation group was lower than the control group; the PLT level of the two groups was significantly higher, the observation group was higher than the control group (P<0.05) and the adverse reaction was 15.00% in the observation group and 35.00% in the control group (P<0.05). 

Conclusion: Low molecular weight heparin calcium combined with insulin is effective in patients with high triglyceride acute pancreatitis with low clinical adverse reactions. It can significantly regulate immune function, inhibit inflammatory response and improve haemorheology and coagulation function, which can be promoted clinically to help patients improve their condition.

Keywords

Low molecular weight heparin calcium, insulin, high triglyceride acute pancreatitis, immune function, inflammatory response, haemorheology, coagulation function.

DOI:

10.19193/0393-6384_2020_3_243