Ulinastatin-somatostatin combination for acute severe pancreatitis: enhanced clinical efficacy and reduced serum inflammation.

Abstract

Objective: To analyze the clinical effect of ulinastatin (UTI)-somatostatin (SS) combination on acute severe pancreatitis (SAP) patients, focusing on changes in efficacy and serum inflammatory markers (IMs).

Methods: This study retrospectively enrolled 104 SAP patients (July 2022-July 2025), with 51 patients (control group) treated with SS and 53 cases (observation group) receiving UTI+SS. Clinical efficacy, safety (rash, dizziness, diarrhea, nausea/vomiting, kidney injury, hyperglycemia), symptom relief time (vomiting, pyrexia, celialgia, defecation recovery, abdominal distension), disease-related indicators (blood amylase [AMS], Acute Physiology And Chronic Health Evaluation II [APACHE-II]), pancreatic function (insulin [INS], trypsinogen-2 [TPS2], glucose [Glu]), serum IMs (C-reactive protein [CRP], tumor necrosis factor [TNF]-α, interleukin [IL]-6), intestinal mucosal barrier function (diamine oxidase [DAO], D-lactic acid [D-Lac], endotoxin [ET]), laboratory-related indexes (total white blood cell count [WBC], platelet count [PLT], creatinine [Cr], total bilirubin [TBIL]), and humoral immunity (immunoglobulin [Ig] A/M/G) were comparatively assessed. Finally, determinants of patients' therapeutic effects were isolated by uni- and multivariate analyses.

Results: UTI+SS was markedly superior to sole SS in terms of overall effectiveness, INS, PLT, and IgA/M/G, along with faster symptom relief, lower AMS, APACHE-II scores, TPS2, Glu, CRP, TNF-α, IL-6, DAO, D-Lac, WBC, Cr, and TBIL. Total adverse reaction incidence showed no notable inter-group difference. CRP and Cr were independent risk factors for therapeutic efficacy among SAP patients, while treatment modality acted as an independent protective factor.

Conclusion: UTI+SS for SAP is effective in clinical efficacy enhancement and serum inflammation suppression.