THERAPEUTIC EFFECT OF COMBINED ULINASTATIN AND GLUTAMINE FOR EARLY ENTERAL NUTRITION IN PATIENTS WITH SEVERE PANCREATITIS

This study investigated the therapeutic effect of combining ulinastatin and glutamine with early enteral nutrition in patients with severe pancreatitis.A retrospective analysis was conducted on 104 patients admitted between June 2020 and June 2022, divided equally into control and experimental groups.The control group received ulinastatin and early enteral nutrition, while the experimental group received an additional glutamine supplement over two weeks.Results showed that the experimental group had significantly better clinical outcomes, including faster symptom recovery and improved biochemical parameters.Inflammatory markers such as LPS, TNF- and IFN- decreased, while IL-2 levels increased.Gut flora improved with a decrease in Escherichia coli and Staphylococcus, and an increase in Bifidobacterium.Additionally, markers of oxidative stress, gut permeability, and organ function improved more significantly in the experimental group.Immune function indicators, including CD3 + , CD4 + /CD8 + , neutrophil count, and CRP, also showed favourable changes.APACHE II scores and the incidence of complications were significantly lower in the experimental group.These findings suggest that the combined therapy of ulinastatin and glutamine enhances clinical efficacy, modulates inflammation, supports intestinal and immune function, and may offer a valuable approach to treating severe pancreatitis. RezumatAcest studiu a investigat efectul terapeutic al administrrii combinate de ulinastatin i glutamin, n asociere cu nutriia enteral precoce, la pacienii cu pancreatit sever.A fost realizat o analiz retrospectiv pe un numr de 104 pacieni internai n perioada iunie 2020 -iunie 2022, mprii n mod egal ntr-un grup de control i un grup experimental.Grupul de control a primit tratament cu ulinastatin i nutriie enteral precoce, n timp ce grupul experimental a beneficiat suplimentar de administrarea de glutamin timp de dou sptmni.Rezultatele au artat c pacienii din grupul experimental au avut evoluii clinice semnificativ mai bune, cu o recuperare mai rapid a simptomatologiei i mbuntirea parametrilor biochimici.Markerii inflamatori (LPS, TNF- i IFN-) au sczut semnificativ, n timp ce nivelurile de IL-2 au crescut.Flora intestinal s-a mbuntit, fiind observat o reducere a populaiilor de Escherichia coli i Staphylococcus, concomitent cu o cretere a numrului de Bifidobacterium.De asemenea, parametrii de stres oxidativ, permeabilitate intestinal i funcie organic au nregistrat ameliorri semnificative n grupul experimental.Markerii funciei imune, inclusiv CD3 + , raportul CD4 + /CD8 + , numrul de neutrofile i CRP, au prezentat mbuntiri.Scorurile APACHE II, precum i incidena complicaiilor, au fost semnificativ mai mici n grupul experimental.n concluzie, terapia combinat cu ulinastatin i glutamin mbuntete eficacitatea clinic, moduleaz rspunsul inflamator, susine funciile intestinal i imun i ar putea reprezenta o opiune n tratamentul pancreatitei severe.