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World J Gastroenterol. Jan 21, 2008; 14(3): 474-478
Published online Jan 21, 2008. doi: 10.3748/wjg.14.474
Impact of alanyl-glutamine dipeptide on severe acute pancreatitis in early stage
Ping Xue, Li-Hui Deng, Qing Xia, Zhao-Da Zhang, Wei-Ming Hu, Xiao-Nan Yang, Bing Song, Zong-Wen Huang
Ping Xue, Li-Hui Deng, Qing Xia, Xiao-Nan Yang, Zong-Wen Huang, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Zhao-Da Zhang, Wei-Ming Hu, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Bing Song, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Correspondence to: Professor Zong-Wen Huang, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. huangzongwen@medmail.com.cn
Telephone: +86-28-85423373
Fax: +86-28-85423028
Received: August 1, 2007
Revised: October 23, 2007
Published online: January 21, 2008
Abstract

AIM: To evaluate the therapeutic effect of alanyl-glutamine dipeptide (AGD) in the treatment of severe acute pancreatitis (SAP) in early and advanced stage.

METHODS: Eighty patients with SAP were randomized and received 100 mL/d of 20% AGD intravenously for 10 d starting either on the day of (early treatment group) or 5 d after (late treatment group) admission. Groups had similar demographics, underlying diseases, Ranson score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Balthazar’s computed tomography (CT) score at the beginning of the study and underwent similar other medical and nutritional management.

RESULTS: The duration of acute respiratory distress syndrome (2.7 ± 3.3 d vs 12.7 ± 21.0 d, P < 0.01), renal failure (1.3 ± 0.5 d vs 5.3 ± 7.3 d, P < 0.01), acute hepatitis (3.2 ± 2.3 d vs 7.0 ± 7.1 d, P < 0.01), shock (1.7 ± 0.4 d vs 4.8 ± 3.1 d, P < 0.05), encephalopathy (2.3 ± 1.9 d vs 9.5 ± 11.0 d, P < 0.01) and enteroparalysis (2.2 ± 1.4 d vs 3.5 ± 2.2 d, P < 0.01) and hospital stay (28.8 ± 9.4 d vs 45.2 ± 27.1 d, P < 0.01) were shorter in the early treatment group than in the late treatment group. The 15-d APACHE II score was lower in the early treatment group than in the late treatment group (5.0 ± 2.4 vs 8.6 ± 3.6, P < 0.01). The infection rate (7.9% vs 26.3%, P < 0.05), operation rate (13.2% vs 34.2%, P < 0.05) and mortality (5.3% vs 21.1%, P < 0.05) in the early treatment group were lower than in the late treatment group.

CONCLUSION: Early treatment with AGD achieved a better clinical outcome in SAP patients.

Keywords: Severe acute pancreatitis; Alanyl-glutamine dipeptide; Clinical study