血小板活化因子拮抗剂对犬重症急性胰腺炎血循环障碍的干预

目的：探讨重症急性胰腺炎（SAP）血循环障碍的发病机制及其血小板活化因子拮抗剂（WEB2170）的干预效果。方法：实验分三组：正常对照组（NC，n＝5）、重症急性胰腺炎组（SAP，n=6），和WEB2170干预组（WEB,n=6）。用5％牛磺胆酸钠和牛胰蛋白酶混合液胰管注入，制备犬SAP模型。WEB组于模型制备后15min和12h分别静脉注射WEB2170（5mg/kg)。术后动态观察各组以下指标：血液流变学，血小板活化因子（PAF）、血栓素TXA2（TXA2），前列腺素I2（PGI2）、内皮素（ET）和一氧化氮（NO）。结果：SAP组TXA2、PGI2、ET、NO、PAF较NC组显著升高（P＜0．01），血液流变学指标也有显著的改变（P＜0．01）；WEB2170对PAF有显著的干预（P＜0．01），对其它指标也有明显的干预（P＜0．05）。结论：血液流变学、炎性介质PAF、两对血管活性物质即TXA2／PGI2和ET／NO均是介导SAP胰腺血循环障碍的重要因素，血小板活化因子拮抗剂是其有效的干预措施之一。

An intervention of a PAF receptor antagonist in the hemocirculatory disorder of the dogs with severe acute pancreatitis

Objective To study the mechanism of hemocirculatory disorder in the dogs with severe acute pancreatitis(SAP) and the intervener of a platelet activating factor(PAF) receptor antagonsit WEB2170.Methods Seventeen dogs were divided randomly into three groups that were normal control group(NC,n=5), severe acute pancreatitis group(SAP,n=6) and WEB2170 group(WEB,n=6).SAP models were established by injecting 5% sodium taurocholate and trypesin into the main pancreatic duct. The dogs of WEB group were injected WEB2170(5mg/kg) intravenously at 15 minuts and 12 hours respectively after the severe acute pancreatitis successfully established.The changes of indexes including hemorrheologic parameters,PAF, thromboxane A 2(TXA 2), prostaglandin I 2(PGI 2), endothelin(ET) and nitric oxide(NO) were dynamically determined after operations.Results During SAP, the levels of PAF, TXA 2,PGI 2,ET and NO were progressively increased( P <0 01), sd wellas the hemorrheologic parameters were significantly elevated( P <0 01). After treated with WEB2170,the PAF level was inhibited significantly( P <0 01), and the others metioned above were prevented in varying degrees( P <0 05).Conclusion The changes of hemorrheologic parameters, PAF, TXA 2,PGI 2,ET and NO level might play key roles in the mechanism of hemocirculatory disorder in dogs with severe acute pancreatitis(SAP).WEB2170 might be one of important intervener.