加贝酯对犬胰腺移植后Oddi括约肌及外分泌功能的影响

Effects of Gabexate Mesilate on Oddi sphincter motility and exocrine function after pancreatic transplantation in dogs

目的研究加贝酯对膀胱引流式犬胰腺移植后移植物Oddi括约肌(SO)和外分泌功能的影响。方法正常犬和膀胱引流式胰腺移植后犬应用加贝酯前后进行SO测压,检测移植后犬应用加贝酯前后尿中胰蛋白原激活肽(TAP)和淀粉酶水平。结果正常犬SO有规律收缩,基础压为(19．4±3．2)mmHg,收缩频率为(9．9±1．6)次／min,收缩幅度为(45．1±6．5)mmHg,动力指数为355．4±31．3。应用加贝酯后SO收缩频率和动力指数分别下降为(4．8±0．9)次／min和206．5±21．4,与用药前相比,差异均有统计学意义(P<0．01)。基础压和收缩幅度无明显变化(P>0．05)。胰腺移植后,犬移植物SO基础压和收缩频率分别升高为(27．2±5．6)mmHg和(13．8±2．5)次／min,收缩幅度缩小为(8．6±2．5) mmHg,动力指数无明显变化。移植犬应用加贝酯后,SO基础压、收缩频率、收缩幅度和动力指数分别降低为(18．6±2．9)mmHg、(8．6±2．5)次／min、(5．4±0．9)mmHg和136．9±3．5,与用药前相比,差异均有统计学意义(P<0．01)。用加贝酯后尿淀粉酶和TAP水平分别为(6 000±290)IU／L和(16．7±3．8) nom／L,与用药前相比,有显著性差异(P<0．01)。结论加贝酯可抑制犬SO运动,尤其胰腺移植后,抑制作用更加显著。加贝酯还可以降低膀胱引流式犬胰腺移植后尿中的胰蛋白酶原激活肽和尿淀粉酶水平,从而有助于防治移植物胰腺炎。

Objective To study the effect s of Gabexate Mesilate on Oddi sphincter （SO） motility and graft exocrine function after pancreatic transplantation with bladder drainage in dogs. Methods SO manometry was performed in normal dogs and those receiving pancreatic transplantation with bladder drainage before and after administration of Gabexate Mesilate. The urinary trypsinogen activation peptide （TAP） and amylase were determined before and after administration of Gabexate Mesilate. Results In the normal dogs, basal pressure, the contract frequency and amplitude, and motility index of SO were （19.4 ± 3.2）mmHg, （9.9 ±1.6） per rain, （45.1 ±6.5） mmHg and （355.4 ± 31.3）, respectively. After the administration of Gabexate Mesilate, the frequency and motility index of SO were significantly decreased to （4.8 ± 0. 9） per rain and （206. 5 ±21. 4）, as compared with the controls （P 〈 0. 01）. There were no significant changes in SO basal pressure and amplitude. In the dogs receiving pancreatic transplantation, the basal pressure and the frequency of SO were increased to （27.2 ± 5.6） mmHg and （13.8 ± 2.5） per min, amplitude decreased to （8.6 ± 2.5） mmHg, and there was no significant changes in motility index. After the administration of Gabexate Mesilate, SO basal pressure, the contract frequency and amplitude, and motility index were significantly decreased to （18.6 ± 2.9） mmHg, （8.6 ± 2.5） per min, （5.4 ± 0.9） mmHg and （136.9± 3.5） in the dogs receiving the pancreatic transplantation （P 〈 0. 01）. Urine amylase and TAP were significantly decreased to （6000 ± 290） IU/L and （16.7 ± 3.8） nom/L after the administration of Gabexate Mesilate （P 〈 0.01）. Conclusions Gabexate Mesilate can inhibit SO motility in normal dogs, especially ones receiving pancreatic transplantation. Meanwhile, it can decrease urinary levels of amylase and TAP. This will help to prevent graft pancreatitis.