摘要
目的探讨磷脂酶Ａ２抑制剂－依地酸钙钠（ＣａＮａ２ ＥＤＴＡ）区域动脉灌注治疗急性出血坏死性胰腺炎（ＡＨＮＰ）的疗效及其机理。方法在胆胰管内注入５％牛磺胆酸钠诱发Ｗｉｓｔｅｒ大鼠急性出血坏死性胰腺炎后３０分钟，行胰十二指肠动脉插管。动脉灌注磷酯酶Ａ２抑制剂质量浓度为０．５％的ＣａＮａ２ ＥＤＮａ２ ＥＤＴＡ３．６ｍｌ，并与不治疗组、区域灌注生理盐水组及外周用质量浓度为０．５％的ＣａＮａ２ＥＤＴＡ３．６ｍｌ３组对照。术后４小时、９小时，测血清淀粉酶、脂肪酶、磷脂酶Ａ２，并取胰腺标本行光镜、透射电镜检查。结果依地酸钙钠区域动脉灌注组在ＡＨＮＰ后４小时血清各酶明显低于其它３组（Ｐ＜０．０５）。胰腺光镜示出血坏死明显减轻，电镜示线粒体较多，分泌颗粒小且少，内质网肿胀坏死明显减轻，无溶酶体膜及核膜破裂。结论①应用ＣａＮａ２ ＥＤＴＡ，从抑制ＰＬＡ２活性入手治疗ＡＨＮＰ效果确切，可行。②区域动脉灌注为一治疗ＡＨＮＰ的增效途径。
Objective To study the therapeutic effect and mechanism of phospholipase A2(PLA2) inhibitor CaNa2 EDTA in tratment of AHNP by local intra-arterial infusion. Methods Wistar rats of AHNP modelwere estahlied by intra-bilopancreatic duct infusion of 5% sodium taurocholate. thirty minutes later intubation ofpancreaticoduodenal artery wes done and 3.6ml of 0.5% CaNa2 EDTA were infused. There were 3 controlgroups: a non-treatment group, a NS infusion group, and a peripheral venous 0. 5% CaNa2 EDTA infusion group.Serum amylase, lipase and PLA2 were determined 4 and 9 hours after the above procedures, and subsequently lightand transmission electron microscopies of pancreatic specimen were. done. Results It was found that all serum enzymes in the local treatment group were significantly lower than those in all the control groups and there was a significant statistical differences between the infusion group at 4hr after AHNP and the control (P<0.05).Light nmicroscopy found less hemorrhage and necrosis in the local treatment group than in the control groups. Electron microscopy found more mitochnondria, less secretory granules, reduced endoplasmic reticulum enlargement, milder necrosis, and no lysosomal or nuclear membrane bursting in the local treatment group as compared with thecontrol groups. Conclusion ①The method of treatment of AHNP by reducing the activity of PLA2 is effective andreliable; ②Local intra-arterial infuSion is one of the means of improving therapeutic effect of drugs against AHNP.
出处
《中华肝胆外科杂志》
CAS
CSCD
1999年第2期97-99,共3页
Chinese Journal of Hepatobiliary Surgery
关键词
急性胰腺炎
区域动脉灌注
依地酸钙钠
Acute pancreatitis
Local intra-arterial infusion
CaNa_(2)EDTA
