西米替丁对急性胰腺炎的影响及机制探讨

The Effect and Mechanism of Cimetidine on Acute Pancreatitis

目的:探讨西米替丁治疗急性胰腺炎的利弊及其机制。方法:对156例急性水肿型胰腺炎患者进行传统疗法与传统疗法加西米替丁的治疗对照研究,并检测了50例消化性溃疡患者服用西米替丁前后的血清胃泌素及24例急性胰腺炎患者急性发病期的血清胃泌素。结果西米替丁组腹痛消失时间、血尿淀粉酶下降时间、住院时间均较对照组明显延长。另有40.16％(51/127)的患者出现病情反复。溃疡病患者服用西米替丁后血清胃泌素明显升高。急性胰腺炎发病期血清胃泌素明显高于正常,发病当日超过正常值4～10余倍。结论:急性胰腺炎的发病可能与血清胃泌素过高有关,西米替丁虽能降低胃酸,但因反馈性升高血清胃泌素而不利于急性胰腺炎的恢复。

Aims: to study the effect of cimetidine on acute pancreatitis and the mechanism of cimetidine postponing recuperation of acute pancreatitis. Methods: All of 156 patients received nosogastric suction and anisodamine hydrobromid were injected intramuscular, 10 mg three times a day. Besides, cimetidine were venoclysised, 0. 4 g two times a day in 127 patients among them. Response to treatment (abdominal pain, serum and uric amylase) were observed. The serum gastrin of 50 patients with peptic ulcer were measured before and after cimetidine taken. The serum gastrin of 24 patients with acute pancreatitis also were measured. Results: By contrast, the serum and urine amylase and abdominal pain remained abnonnal significantly longer and that relapsed in 51 patients with acute pancreatitis in cimetidine group. The serum gastrin of patients with peptic ulcer after administration of cimetidine were significantly higher than before. The serum gastrin of patients with acute pancreatitis were significantly elevated. Conclusion: It suggests that attacking of acute pancreatitis is strongly related to elevation of serum gastrin of patients. Cimetidine may postpone recuperation of acute pancreatitis. It may results from elevation of serum, gastrin by cimetidine administered.