甲磺酸加贝酯在内镜逆行胰胆管造影检查后是否会影响急性期蛋白的血清浓度？

Does gabexate mesilate affect serum concentrations of acute phase proteins after endoscopic retrograde cholangiopancreatography examination?

作者信息

Pezzilli Raffaele, Gabbrielli Armando, Labate Antonio Maria Morselli, D'Alessio Pasquale, Barakat Bahjat, Costamagna Guido, Dibenedetti Francesco, Massa Margherita, Merlini Giovanni, d'Eril Gianvico Melzi

机构信息

Department of Internal Medicine, Azienda Ospedaliera Policlinico S. Orsola-Malpighi, Bologna, Italy.

出版信息

Hepatogastroenterology. 2003 May-Jun;50(51):851-5.

PMID:12828103

Abstract

BACKGROUND/AIMS: To explore the possibility that the preventive effect of gabexate mesilate on endoscopic retrograde cholangiopancreatography-related acute pancreatitis may be mediated by its modulation of acute phase proteins.

METHODOLOGY

Thirty consecutive patients who underwent endoscopic retrograde cholangiopancreatography were randomly assigned to receive 1g of gabexate mesilate (13 patients) or a placebo (17 patients) by continuous i.v. infusion starting 30 minutes before the endoscopy session and continuing for 12 hours afterward. In all patients, C-reactive protein, serum amyloid A and interleukin 6 serum concentrations were determined before endoscopy and 4, 8, 12 and 24 hours afterward.

RESULTS

Interleukin 6 basal serum concentrations were not statistically different between patients who had been treated with gabexate mesilate and those who had received the placebo (P = 0.279), whereas C-reactive protein (P = 0.033) and serum amyloid A (P = 0.022) basal values were significantly lower in the gabexate mesilate group than in the placebo group. Compared to basal values, serum interleukin 6 concentrations significantly increased at 4 (P = 0.048) and at 8 (P = 0.025) hours; the increase of serum interleukin 6 concentrations was not significant at 12 (P = 0.092), but became significant at 24 (P = 0.025) hours. C-reactive protein and serum amyloid A serum concentrations increased significantly only at 12 (P = 0.001, P = 0.012, respectively) and 24 (P < 0.001, P = 0.013, respectively) hours. The modifications of serum concentrations of interleukin 6, C-reactive protein and serum amyloid A were not significantly different between the gabexate mesilate and the placebo groups.

CONCLUSIONS

Gabexate mesilate does not affect serum concentrations of acute phase proteins after endoscopic retrograde cholangiopancreatography examination and it is able to prevent acute pancreatitis related to endoscopic retrograde cholangiopancreatography via a different mechanism than that explored in this study.

摘要

背景/目的：探讨甲磺酸加贝酯对内镜逆行胰胆管造影术相关急性胰腺炎的预防作用是否可能通过其对急性期蛋白的调节来介导。

方法

连续30例接受内镜逆行胰胆管造影术的患者被随机分配，通过静脉持续输注，在内镜检查开始前30分钟给予1g甲磺酸加贝酯（13例患者）或安慰剂（17例患者），并在之后持续12小时。对所有患者，在内镜检查前以及检查后4、8、12和24小时测定C反应蛋白、血清淀粉样蛋白A和白细胞介素6的血清浓度。

结果

甲磺酸加贝酯治疗组患者与接受安慰剂治疗的患者之间，白细胞介素6基础血清浓度无统计学差异（P = 0.279），而甲磺酸加贝酯组的C反应蛋白（P = 0.033）和血清淀粉样蛋白A（P = 0.022）基础值显著低于安慰剂组。与基础值相比，血清白细胞介素6浓度在4小时（P = 0.048）和8小时（P = 0.025）时显著升高；血清白细胞介素6浓度在12小时时升高不显著（P = 0.092），但在24小时时变得显著（P = 0.025）。C反应蛋白和血清淀粉样蛋白A血清浓度仅在12小时（分别为P = 0.001，P = 0.012）和24小时（分别为P < 0.001，P = 0.013）时显著升高。甲磺酸加贝酯组和安慰剂组之间，白细胞介素6、C反应蛋白和血清淀粉样蛋白A血清浓度的变化无显著差异。