Impact of alanyl-glutamine dipeptide on severe acute pancreatitis in early stage

AIM: To evaluate the therapeutic effect of alanylglutamine 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. (c) 2008 WJG. All rights reserved.