Colak T, Ipek T, Paksoy M, Polat E, Uygun N, Kayabaşi B
Department of Surgery, Cerrahpaşa Medical Faculty of Istanbul University, Turkey.
Surg Today. 2001;31(6):502-6. doi: 10.1007/s005950170109.
The preventive effects of granulocyte colony-stimulating factor, cefephim, and sucralfate on bacterial translocation in experimentally induced acute pancreatitis were investigated. Forty male Wistar albino rats were used in this study. For each rat, the pancreatobiliary ductus was ligated and hence acute pancreatitis was induced. In the control group, no further procedure was performed. Meanwhile, cefephim as an antibiotic, filgrastim, which is a colony-stimulating factor, and sucralfate were given to the other groups at the specified doses. To inhibit bacterial translocation by preserving the bowel barrier, sucralfate, which is known to have a cytoprotective effect on the gastrointestinal system, was used in high doses. Cefephim 30 mg/kg per day (intramuscularly) in group II, filgrastim 10 mg/kg per day (subcutaneously) in group III, and sucralfate 50 mg/kg per day by 8-F feeding tube gavage into the stomach in group IV were given. The number of bacteria translocated into the mesenteric lymph nodes, pancreas, liver, and spleen in the control group significantly increased in comparison with the other groups (P < 0.05). The average number of leukocytes (per mm3) in the control group was significantly higher than that of other groups (P < 0.0001). Regarding the average serum amylase levels, the values of all groups clearly decreased in comparison with the control group (P < 0.0001). Although in the cefephim, filgrastim, and sucralfate groups, (+) pancreatitis was generally seen, in the control group (+++) pancreatitis was detected. Bacterial translocation to the mesenteric lymph nodes and pancreas was partially prevented by filgrastim and sucralfate, and was completely prevented by cefephim. We conclude that in the management of acute pancreatitis, the use of the prophylactic antibiotics, sucralfate and filgrastim, may be advantageous.
研究了粒细胞集落刺激因子、头孢匹姆和硫糖铝对实验性诱导的急性胰腺炎中细菌移位的预防作用。本研究使用了40只雄性Wistar白化大鼠。对每只大鼠结扎胰胆管,从而诱导急性胰腺炎。对照组未进行进一步操作。同时,向其他组以指定剂量给予作为抗生素的头孢匹姆、作为集落刺激因子的非格司亭和硫糖铝。为通过保护肠屏障抑制细菌移位,使用了已知对胃肠系统具有细胞保护作用的高剂量硫糖铝。第二组每天肌肉注射头孢匹姆30mg/kg,第三组每天皮下注射非格司亭10mg/kg,第四组通过8F饲管每天向胃内灌胃硫糖铝50mg/kg。与其他组相比,对照组中移位至肠系膜淋巴结、胰腺、肝脏和脾脏的细菌数量显著增加(P<0.05)。对照组白细胞平均数量(每立方毫米)显著高于其他组(P<0.0001)。关于平均血清淀粉酶水平,与对照组相比,所有组的值均明显降低(P<0.0001)。虽然在头孢匹姆、非格司亭和硫糖铝组中,一般可见(+)级胰腺炎,但在对照组中检测到(+++)级胰腺炎。非格司亭和硫糖铝可部分预防细菌向肠系膜淋巴结和胰腺的移位,头孢匹姆可完全预防。我们得出结论,在急性胰腺炎的治疗中,使用预防性抗生素、硫糖铝和非格司亭可能是有益的。