To observe the clinical efficacy of short-term intensive insulin therapy combined with blood purification in the treatment of hypertriglyceridemic severe acute pancreatitis (HTG-SAP).

HTG-SAP patients were divided into control group and treatment group based on the treatment method. The control group received continuous blood purification (CBP) treatment for 24 to 48 hours, and the next treatment was performed after a 24-hour interval for a total of 2 treatments. The treatment group received continuous intravenous pumping of CBP combined with 0.1-0.3 U·kg^-1·h^-1 insulin injection. The course of treatment in both groups was 7 days. The clinical efficacy, clinical symptom relief time, prognostic indicators, clinical scores, blood lipid levels, inflammation and biochemical factor levels were compared between the two groups, and safety was evaluated.

A total of 78 patients were enrolled, with 41 cases in control group and 37 cases in treatment group. The total effective rates of treatment in the treatment group and the control group were 89.19% (33 cases/37 cases) and 70.73% (29 cases/41 cases), respectively, with statistical significance differences between the two groups (P<0.05). After treatment, the disappearance times of abdominal distension in the treatment and control groups were (6.27±1.10) and (6.93±1.27) days, respectively; the disappearance times of abdominal pain were (4.97±0.80) and (5.46±1.10) days, respectively; the recovery times of bowel sounds were (3.14±0.63) and (3.56±0.71) days, respectively; the first defecation times were (4.08±0.86) and (4.66±1.33) days, respectively; the total hospitalization times were (17.78±3.29) and (19.54±4.15) days, respectively. the recovery times of organ failure were (6.32±1.62) and (7.24±2.13) days, respectively; the incidences of local complications were 8.11% (3 cases/37 cases) and 26.83% (11 cases/41 cases), respectively; the incidences of systemic complications were 10.81% (4 cases/37 cases) and 29.27% (12 cases/41 cases), respectively; the Bedside Index for Severity in Acute Pancreatitis (BISAP) scores were (1.51±0.51) and (1.83±0.38) points, respectively; the Acute physiology and chronic health evaluation scoring system (APACHE II) scores were (6.05±1.13) points and (6.88±1.44) points, respectively; triglyceride (TG) levels were (4.63±1.07) mmol·L^-1 and (5.41±1.26) mmol·L^-1, respectively; total cholesterol (TC) were (4.95±1.01) and (5.73±1.27) mmol·L^-1, respectively; low-density lipoprotein cholesterol (LDL-C) were (2.87±0.43) and (3.15±0.56) mmol·L^-1, respectively; serum amylase (AMY) levels were (138.46±25.49) and (159.85±33.43) U·L^-1, respectively; interleukin-8 (IL-8) levels were (28.65±5.15) and (32.18±6.42) pg·mL^-1, respectively; C-reactive protein (CRP) levels were (29.88±4.81) and (33.12±6.01) mg·L^-1, respectively; the differences of above indexes were all statistically significant (all P<0.05). The incidence of drug adverse reactions of the treatment group and the control group were 5.41% (2 cases/37 cases) and 2.44% (1 case/41 cases), respectively and there was no statistical significance between the two groups (P>0.05).

Short-term intensive insulin therapy combined with blood purification can effectively improve the clinical efficacy of HTG-SAP patients, significantly improve clinical symptoms, organ function recovery, clinical scores, blood lipids, inflammation and biochemical indicators, and does not increase the risk of adverse reactions, which has clinical application value.