川芎嗪对急性出血坏死性胰腺炎血流变学的影响及治疗作用

本文采用胰管加压注入犬自身胆汁的方法制成犬急性出血坏死性胰腺炎(AHNP)模型,动态观察了术前、术后血流变学的改变及川芎嗪的治疗作用。将12只犬随机等分为对照组(制成AHNP)和治疗组(制成AHNP后给川芎嗪静注)动态观察术前、后犬的血流变学和血淀粉酶变化,并于术后24小时剖腹,观察腹水的量及性状、胰腺大体病理改变,并计算胰腺坏死范围占胰腺的百分比。结果发现:随着急性坏死性胰腺炎病程的发展,实验犬全血粘度进行性升高,术后1小时与术前比即有显著差别(P<0.01)。给以改善血流变学特性的药物川芎嗪注射后,明显地降低了治疗犬的血粘度、血淀粉酶及胰腺坏死范围(P值均小于0.01)。提示血流变学异常在AHNP病变恶化中占有重要地位,改善血粘度进而提高胰腺血供对阻止胰腺病变发展是有益的。

THE HEMORHEOLOGIC CHANGES IN ACUTE HEMORRHAGIC NECROTIZING PANCREATITIS AND THE THERAPEUTIC EFFECT OF TETRAMETHYPYRAZINE

Acute hemorrhagic necrotizing pancreatitis (AHNP) was induced in two groups of anesthetized dogs by injection of the autogenous bile into the main pancreatic duct. Thirty minutes after injection, the dogs of group A were given no treatment and Tetramethypyrazine (30mg/kg, i. v.) was given to that of group B. Blood samples were collected for the measurements of blood viscosity, hematocrit and amylopsin at 0.5 hour preoperation and 1,4 and 7 hours after the injection. The necrotic range of pancreas was observed 24 hours after the bile injection. The results showed that the blood viscosity, hematocrit and amylopsin increased progressively during the post-injtction period compared with the preoperative period in group A (P<0.01). After using the Tetramethypyrazine, the dogs in group B showed significant decrease in blood viscosity, hematocrit, amylopsin, and necrotic range of pancreas. Our data indicate that the hemorheologic disturbances is one of the key factors in the pancreatic pathogenesis of AHNP, it aggravate the pathologic lesion of AHNP. Tetramethypyrazine may be useful in the treatment of AHNP.