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Penta-therapy for severe acute hyperlipidemic pancreatitis

  • Author Footnotes
    1 These authors contributed equally to this work and should be considered co-first authors.
    Jian Lu
    Footnotes
    1 These authors contributed equally to this work and should be considered co-first authors.
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work and should be considered co-first authors.
    Yun Xie
    Footnotes
    1 These authors contributed equally to this work and should be considered co-first authors.
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
    Search for articles by this author
  • Jiang Du
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
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  • Mei Kang
    Affiliations
    Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
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  • Wei Jin
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
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  • Yan Li
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
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  • Hui Xie
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
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  • Ruijie Cheng
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
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  • Rui Tian
    Correspondence
    Corresponding author.
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China
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  • Ruilan Wang
    Correspondence
    Correspondence to: R. Wang, Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China.
    Affiliations
    Department of ICU, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, No. 650 New Songjiang Road, Songjiang, Shanghai 201600, China

    Shanghai Key Laboratory of Pancreatic Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of medicine, Shanghai 201600, China
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  • Author Footnotes
    1 These authors contributed equally to this work and should be considered co-first authors.
Published:February 03, 2018DOI:https://doi.org/10.1016/j.ajem.2018.01.092

      Abstract

      Introduction

      The purpose of our study is to evaluate the efficacy of penta-therapy for HL-SAP in a retrospective study.

      Methods

      Retrospective study between January 2007 and December 2016 in a hospital intensive care unit. HL-SAP patients were assigned to conventional treatment alone (the control group) or conventional treatment with the experimental protocol (the penta-therapy group) consists of blood purification, antihyperlipidemic agents, low-molecular weight heparin, insulin, covering the whole abdomen with Pixiao (a traditional Chinese medicine). Serum triglyceride, serum calcium, APACHE II score, SOFA score, Ranson score, and other serum biomarkers were evaluated. The hospital length of stay, local complications, systematic complications, rate of recurrence, overall mortality, and operation rate were considered clinical outcomes.

      Results

      63 HL-SAP patients received conventional treatment alone (the control group) and 25 patients underwent penta- therapy combined with conventional treatment (the penta-therapy group). Serum amylase, serum triglyceride, white blood cell count, C-reactive protein, and blood sugar were significantly reduced, while serum calcium was significantly increased with penta-therapy. The changes in serum amylase, serum calcium were significantly different between the penta-therapy and control group on 7th day after the initiation of treatment. The reduction in serum triglyceride in the penta-therapy group on the second day and 7th day were greater than the control group. Patients in the penta-therapy group had a significantly shorter length of hospital stay.

      Conclusion

      This study suggests that the addition of penta-therapy to conventional treatment for HL-SAP may be superior to conventional treatment alone for improvement of serum biomarkers and clinical outcomes.
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