乌司他丁两种给药途径治疗犬急性出血坏死性胰腺炎  

Study on two administration ways with UTI in the treatment of acute hemorrhagic necotizing pancreatitis

作　　者：朱椰凡[1] 张启瑜[1] 周蒙滔[1] 刘纳新[1] 

机构地区：[1]温州医学院第一附属医院肝胆外科,浙江温州325000

出　　处：《肝胆胰外科杂志》2011年第3期247-249,252,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：浙江省卫生厅重点学科基金项目(437210403)

摘　　要：目的探讨乌司他丁(UTI)外周静脉应用和区域动脉灌注两种给药途径对犬急性出血坏死性胰腺炎(AHNP)的治疗效果。方法制备犬AHNP模型,随机分为3组。A组:生理盐水(NS)胃十二指肠动脉灌注;B组:UTI+NS外周静脉注入;C组:UTI+NS胃十二指肠动脉灌注。在不同时间段抽血,测血清淀粉酶、TNF-α含量。测胰腺组织TNF-α、IL-6和ICAM-1的mRNA表达。光镜和电镜下观察胰腺组织的损伤情况。结果①三组模型建立后血清淀粉酶水平明显上升。B组、C组与同时间A组相比,淀粉酶水平下降更多,其中以C组下降最明显。②三组模型建立后血清TNF-α水平均明显上升,B组只在部分时间段下降,而C组在各时间段均有下降。③B组、C组胰腺组织TNF-α、IL-6和ICAM-1的mRNA表达明显下调,以C组下调最明显。④光镜和电镜下胰腺组织的损伤以C组最轻。结论早期区域动脉灌注UTI对AHNP具有良好的治疗作用,且效果优于UTI外周静脉应用。Objective To probe the therapeutic efficiency by peripheral vein or regional intra-arterial infusion of ulinastatin（UTI） for acute hemorrhagic necotizing pancreatitis（AHNP） in dogs.Methods The mode of AHNP in dogs was prepared and randomly divided into three groups.Group A： infuse NS via gastroduodenal artery;group B： infuse UTI and NS via peripheral vein;Group C： infuse UTI and NS via gastroduodenal artery.Blood sample were taken for the measurement of amylase and TNF-α in the venous blood.The mRNA expression of TNF-α,IL-6 and ICAM-1 in the pancreatic tissue was measured.Pathological changes in the pancreatic tissue were observed under optical microscope and transmission electron microscope.Results ①The concentration of serum amylase of each group after being modeled was much higher than that before.Compared with group A,group B and C reduced the concentration of serum amylase more,and group C had the most remarkerable effectiveness.②The concentration of TNF-α in the venous blood of each group after being modeled were much higher than that before.In group B,TNF-α was reduced at partial time;but in group C which was reduced all the time.③In group B and C,the mRNA expression of TNF-α,IL-6 and ICAM-1 in the pancreatic tissue were down-regulated,and group C had the most remarkerable effectiveness.④Group C had the most slight pathological change in pancreatic tissue under optical microscope and transmission electron microscope.Conclusion Regional intra-arterial infusion UTI early has the favourable treament effect on AHNP.Its therapeutic efficiency is better than that by peripheral vein.

关 键 词：犬 胰腺炎 灌注 乌司他丁 

分 类 号：R657.51[医药卫生—外科学]