胆囊收缩素拮抗剂对ERCP术后胰腺功能影响的临床研究

目的探讨丙谷胺对逆行胰胆管造影(ERCP)术后胰腺功能的影响。方法43例ERCP术患者随机分为对照组(S组,20例)和丙谷胺组(P组,23例),术前均禁食10h,P组于术前4h、术后4h及24h分别舌下含服丙谷胺400mg。两组均于术前2h、术后4h及24h分别采血备测血清淀粉酶及血浆胆囊收缩素八肽(CCKOP)。结果均顺利完成ERCP。术后,对照组(S组)并发急性胰腺炎3例(15%,3/20),明显高于P组(43%,1/23)(P<005)。P组术后4h血清淀粉酶及血浆CCKOP均明显低于S组(P<005);术后24hP组血浆CCKOP与S组差异无显著意义(P>005),但血清淀粉酶明显低于S组(P<005)。结论丙谷胺可有效抑制CCKOP的作用,保护ERCP术后胰腺的功能,减轻酶血症,预防急性胰腺炎的发生。

The effect of cholecystokinin-receptor antagonist proglumide on the pancreas function of post-ERCP

Objective To evaluate the effect of cholecystokinin-receptor antagonist proglumide on the pancreas function of post-ERCP.Methods 43 patients were divided into control group(group S,20 patients) and proglumide group(group P,23 patients) randomly.Group P was given sublingual tablets 400mg at 4h pre-ERCP,and 4h,24h post-ERCP.Blood was sampled at 4h pre-ERCP,and 4h,24h post-ERCP in all patients,the contents of cholecystokinin-octapeptide(CCK-CP) and the amlyase in plasma were measured.Results The occure rate of acute pancreatitis post-ERCP in group S(15%,3/20) was increased significantly compared with group P(4.3%,1/23)(P<0.05).The contents of CCK-OP and amylase in plasma were low significantly in group P compared with group S at 4h post-ERCP(P<0.05).To compare with group S,the contents of CCK-OP were no significantly difference(P>0.05),but the amylase in plasma were lower significantly in group P at 24h post-ERCP(P<0.05).Conclusion Proglumide can block the action of cholecystokinin-octapeptide,depress the hyperamylasemia and reduce the occur rate of pancreatitis of post-ERCP.