实验性急性坏死性胰腺炎狗血液粘弹性改变

Alteration in Viscoelasticity of Whole Blood from Dogs with Experimental Acute Necrotizing Pancreatitis

为研究血液流变学在急性出血性坏死性胰腺炎(AHNP)发病机理中的作用,将44条杂种狗分成5组。第Ⅰ、Ⅱ组分别为手术对照组和急性间质性胰胰炎组(两组各有8条狗)。第Ⅲ、Ⅳ、Ⅴ组狗的主管内注入牛磺胆酸钠溶液形成实验性急性出血性坏死性胰腺炎。而第Ⅳ、Ⅴ组分别用低分子右旋糖酐40(DX40)和丹参溶液静脉注入作为治疗。在所有5组中动脉血压和中心静脉压于手术前后均未见显著性改变。第Ⅲ、Ⅳ、Ⅴ组的血清淀粉酶和脂肪酶水平在实验性AHNP形成后明显增高。但在第Ⅳ、Ⅴ组用药物治疗后,此两酶水平迅速降低。用Low Shear-30流变测定仪测定血液流变学改变。所有5组血浆粘度在手术前、后无明显变化。第Ⅰ、Ⅱ组狗全血的红细胞压积(HCT),在0.512秒^(-1)和51.2秒^(-1)下的表观粘度(η0.512,η51.2),红细胞聚集指数(AI),复粘度的粘性分量(η′)和弹性分量(η″)、以及弹性模量(G′)在手术前后均无明显改变。然而,上述这些参数在实验性AHNP形成后的第Ⅲ、Ⅳ、Ⅴ组有明显增高。但在第Ⅳ和Ⅴ组用药物治疗后,这些参数持续下降;而且,第Ⅴ组丹参溶液比第Ⅳ组的DX40对于血液流变学改变有更好的改善作用。结果证明血液流变学异常是AHNP时引起胰腺微循环障碍的重要因素,并且血液流变学异常的纠正能改善出血性坏死性胰腺炎的症状。

In order to study the role ofhemorheology in pathogenesis of acutehemorrhagic necrotizing pancreatitis(AHNP), forty four adult hybriddogs were used and divided into 5groups. Groups Ⅰ and Ⅱ were opera-tion control (8 dogs) and acuteinterstitial pancreatits group (8 dogs)respectively. Groups Ⅲ-Ⅴ sufferedfrom AHNP by injection of sodiumtaurocholate into major pancreaticduct. Furthermore, groups Ⅳ and Ⅴwere treated with intravenous Dext-ran 40 solution and Danshen respec-tively. Arterial blood pressure andcentral venous pressure in all 5 groupsdid not have significant changesbefore and after operation. Serumamylase and lipase level of groupsⅢ-Ⅴ were increased obviouslyafter AHNP, but they decreased morerapidly in groups Ⅳ and Ⅴ aftertreatment with drug than those ingroup Ⅲ. Hemorheologic changes were measured with Low Shear 30 sinus.There were no significant changes inplasma viscosity of all 5 groups beforeand after operation. In group Ⅰ andⅡ there were no significant changesin hematocrit (HCT), apparent visco-sities of whole blood at 0.512sec^(-1)(η0.512) and 51. 2sec^(-1)(η51.2),aggregation index of RBC (AI),viscous component (η′) and elasticcomponent (η″) of complex viscosity,and elastic modulus (G′) of wholeblood before and after operation.However, the parameters mentionedabove in groups Ⅲ-Ⅴ were increasedsignificantly after AHNP had beeninduced by experiment. They weredecreased continuously after treamentwith drug in groups Ⅳ and Ⅴ How-ever, the improvement in hemor-heological changes was much betterin group Ⅴ treated with Darshensolution than in group Ⅳ treated withDx40. The results suggested that ab-normalities of hemorheology might bean important factor to introduce thedisturbance of microcirculation of pa-ncreas during AHNP and correction ofhemorheological abnormalities couldimprove symptoms of pancreatitis.