LAUSR

BACKGROUND Severe acute pancreatitis (SAP) is a severe form of inflammatory disease with a high mortality rate. Ulinastatin, a urinary trypsin inhibitor, has anti-inflammatory properties and may be beneficial to critically ill patients with SAP. Nevertheless, there is currently insufficient evidence to conclude whether there is a dose-effect relationship between ulinastatin and SAP treatment outcomes. The present study examined the efficacy of ulinastatin at different doses in the treatment of SAP. METHODS A retrospective study was conducted examining the clinical outcomes of 130 SAP patients. Patients were categorized into a control group and three groups receiving different daily doses of ulinastatin (200,000; 400,000; and 600,000 IU). The study compared the 1-week mortality rate; the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score; abdominal pain relief time; time to recover a normal heart and respiratory rate; blood amylase, glucose, C-reactive protein, and procalcitonin levels; and white blood cell (WBC) count among the different groups. RESULTS The 400,000 and 600,000 IU groups had significantly lower mortality rates and WBC count compared to the 200,000 IU group (P<0.05). Furthermore, the 400,000 IU group had a significantly shorter abdominal pain relief time compared to the 200,000 IU group (P<0.05). Compared to the 200,000 IU group, the 600,000 IU group had significantly shorter time to recover a normal respiratory rate and a lower APACHE-II score (P<0.05). CONCLUSIONS Ulinastatin can improve the clinical outcomes of patients with SAP but efficacy varies with the dosage.