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

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