重症急性胰腺炎患者早期血液流变学及血管活性指标血栓素A_2、前列环素I_2水平变化  

Early changes in hemorheological parameters and TXA_2 and PGI_2 levels among patients with severe acute pancreatitis

作　　者：梁超[1] 沙盈盈[1] 朱晓明[1] 王雄达[1] 朱玉华[1] 赵震宇[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院普外科,上海200437

出　　处：《临床肝胆病杂志》2014年第6期549-551,共3页Journal of Clinical Hepatology

基　　金：上海市教育委员会科研创新项目(2012JW50)

摘　　要：目的观察重症急性胰腺炎(SAP)患者早期血液流变学指标及血栓素A2(TXA2)、前列环素I2(PGI2)的变化。方法2012年1月至2013年9月住院的32例SAP患者为SAP组,30例体检健康人为NC组。于患者入院后治疗前即静脉采血,平行检测血液流变学指标及血浆TXA2、PGI2水平,并计算TXA2、PGI2比值。结果比较进行t检验。结果 SAP组血液流变学中除红细胞变形指数低于NC组(t=2.185,P<0.05)外,全血高、中、低切黏度、血浆黏度高于NC组(t=2.820、2.755、2.700、3.622,P<0.05),全血高切还原黏度、全血低切还原黏度高于NC组(t=3.391、2.018,P<0.05),红细胞压积、红细胞刚性指数、红细胞聚集指数高于NC组(t=2.980、2.209、2.004,P<0.05)、全血高切相对指数、全血低切相对指数高于NC组(t=2.630、2.440,P<0.05);SAP组TXA2、PGI2、TXA2、PGI2比值高于NC组(t=3.256、2.589、2.640,P<0.05)。结论 SAP患者早期即存在血液流变性异常及血管内皮细胞活性增高。Objective To investigate the early changes in hemorheological parameters and thromboxane A2 （TXA2 ）and prostacyclin （PGI2 ）levels among patients with severe acute pancreatitis （SAP）.Methods Thirty-two SAP patients hospitalized from January 2012 to September 2013 were selected as SAP group;30 healthy controls were selected as normal control （NC）group.Venous blood was collected after admission and before treatment.The hemorheological parameters and plasma levels of TXA2 and PGI2 were determined,and TXA2/PGI2 ratio was calculated.Comparison between groups was made by t test.Results Compared with the NC group,the SAP group had a sig-nificantly lower erythrocyte deformation index （t=2.185,P 〈0.05）,significantly higher whole blood viscosities at high-,middle-,and low-shear rates and plasma viscosity （t=2.820,2.755,2.700,and 3.622,P〈0.05）,significantly higher whole blood reduced viscosi-ties at high-and low-shear rates （t=3.391 and 2.018,P〈0.05）,a significantly higher hematocrit （t=2.980,P〈0.05）,a signifi-cantly higher erythrocyte rigidity index （t=2.209,P〈0.05）,a significantly higher erythrocyte aggregation index （t=2.004,P〈0.05）, a significantly higher whole blood relative index at high shear rate （t=2.630,P〈0.05）,a significantly higher whole blood relative index at low shear rate （t=2.440,P〈0.05）,a significantly higher TXA2 level （t=3.256,P〈0.05）,a significantly higher PGI2 level （t=2.589,P〈0.05）,and a significantly higher TXA2/PGI2 ratio （t=2.640,P〈0.05）.Conclusion Hemorheological disorders and in-creased activity of vascular endothelial cells appear in the early stage in SAP.

关 键 词：胰腺炎 急性坏死性 血液流变学 受体 血栓烷A2 前列腺素H2 依前列醇 

分 类 号：R576[医药卫生—消化系统]