Wilson C, Imrie C W
Department of Surgery, Royal Infirmary, Glasgow, UK.
Br J Surg. 1990 Nov;77(11):1252-5. doi: 10.1002/bjs.1800771118.
In canine pancreatitis, irreversible hypotension and death follow saturation of the antiprotease molecules in peritoneal exudate by activated proteolytic enzymes which are released from the pancreas. This study has examined, in rats with taurocholate-induced pancreatitis, the efficacy of removal of the peritoneal exudate by aspiration and a single lavage, followed by instillation of an exogenous antiprotease solution. Instillation of human fresh frozen plasma, containing alpha 2-macroglobulin and alpha 1-antiprotease, was associated with the longest median survival. Aprotinin, although possessing a much greater trypsin inhibitory capacity, just failed to significantly improve the median survival time compared with the control group. Intraperitoneal antiprotease therapy is simple to perform, has a beneficial effect on survival time in this model and merits investigation in man.
在犬胰腺炎中,胰腺释放的活化蛋白水解酶使腹膜渗出液中的抗蛋白酶分子饱和后,会出现不可逆的低血压和死亡。本研究在牛磺胆酸盐诱导的胰腺炎大鼠中,检验了通过抽吸和单次灌洗清除腹膜渗出液,随后滴注外源性抗蛋白酶溶液的效果。滴注含有α2-巨球蛋白和α1-抗蛋白酶的人新鲜冷冻血浆,与最长的中位生存期相关。尽管抑肽酶具有更强的胰蛋白酶抑制能力,但与对照组相比,仍未能显著提高中位生存时间。腹腔内抗蛋白酶治疗操作简单,对该模型的生存时间有有益影响,值得在人体中进行研究。