急性坏死性胰腺炎血液流变学改变与治疗

目的通过纠正血液流变学异常，以期阻断胰腺炎不断恶化的病理过程。方法胰胆管注射牛磺胆酸制备大鼠急性胰腺炎模型，术后随机分别输注葡聚糖、生理盐水及葡聚精＋地塞米松。总液量控制在 ６ｍｌ／ｈ，共治疗３小时后，检测血液流变学指标、红细胞脆性试验和胰腺病理学改变。结果急性胰腺炎大鼠全血粘度、血浆粘度、红细胞压积均显著升高，纤维蛋白原降低，红细胞脆性增加。葡聚糖可显著降低急性胰腺炎大鼠的血液粘度、红细胞压积和红细胞脆性，并降低胰腺组织的炎症程度。结论 急性胰腺炎时血液流变学出现显著改变，葡聚糖可通过纠正血液流变学异常降低胰腺组织的炎症程度。

Hemorrheologic Alterations in Acute Necrotizing Pancreatitis and Treatment

Objective To block the deteriorating pathologic process of acute pancreatitis by correcting hemorrheologic abnormality' Method Acute necrotizing pancreatitis was induced in rats by intrapancreatic duct injection of sodium taurocholate and then the rats were divided into a control group (no therapy),dextran,normal saline,dextran plus dexamethasone treatment groups,and a sham group. In treatment groups,dextran, normal saline,dextran plus dexamethasone were administered intravenously respectively,at 5 minutes postoperatively. The amount of administrations was strictly controlled at 6ml/h. After being treated for 3 hours,the rats were killed. Blood samples were obtained for hemorrheologic parameters and erythrocyte osmotic fragility test. Pancreatic tissue was obtained for pathologic study.Result Blood viscosity,plasma viscosity,hematocrit,erythorcyte osmotic fragility elevated,while erythrocyte sedimentation rate and fibrinogen decreased significantly in acute pancreatitis rats compared with the sham group. Blood viscosity,hematocrit and erythrocyte osmotic fragility reduced;fibrinogen elevated significantly; pathologic alterations were improved in both dextran and dextran plus dexametha- sone groups. Conclusion in rats with acute necrotizing pancreatitis,hemorrheology was altered significantly. Dextran can improve the pathologic alterations by correcting hemorrheologic abnormality.