Satake K, Ha S, Hiura A, Nishiwaki H, Haku A, Umeyama K
First Department of Surgery, Osaka City University Medical School, Japan.
Gastroenterol Jpn. 1990 Dec;25(6):720-6. doi: 10.1007/BF02779186.
The coagulation disturbance observed during severe acute pancreatitis before and after the infusion of a new synthetic low molecular weight protease inhibitor (Fut-175) was compared. The coagulo-fibrinolytic changes after acute pancreatitis was induced by the intraductal injection of an autologous bile and trypsin mixture showed decreased platelet counts, decreased plasma fibrinogen levels, prolonged partial prothrombin time and increased fibrinogen degradation products. In addition, markers of hypercoagulation showed increased fibrin-peptide A and decreased antithrombin III. The two markers of fibrinolysis showed increased B beta 15-42 immunoreactive peptide and decreased alpha 2 antiplasmin. After the infusion of Fut-175, the coagulo-fibrinolytic abnormalities, which were observed during severe acute pancreatitis without infusion of Fut-175, were improved. Furthermore, Fut-175 could suppress the rise in fibrino-peptide A and B beta 15-42 immunoreactive peptide and decrease in antithrombin III and alpha 2 antiplasmin. Thus, Fut-175 seems to be an effective inhibitor of protease-mediated hypercoagulation and fibrinolysis in severe acute pancreatitis.
比较了在输注一种新型合成低分子量蛋白酶抑制剂（Fut-175）前后，重症急性胰腺炎期间观察到的凝血紊乱情况。通过导管内注射自体胆汁和胰蛋白酶混合物诱导急性胰腺炎后，凝血-纤溶变化表现为血小板计数减少、血浆纤维蛋白原水平降低、部分凝血活酶时间延长以及纤维蛋白原降解产物增加。此外，高凝指标显示纤维肽A增加，抗凝血酶III减少。纤溶的两个指标显示Bβ15 - 42免疫反应性肽增加，α2抗纤溶酶减少。输注Fut-175后，在未输注Fut-175的重症急性胰腺炎期间观察到的凝血-纤溶异常得到改善。此外，Fut-175可抑制纤维肽A和Bβ15 - 42免疫反应性肽的升高以及抗凝血酶III和α2抗纤溶酶的降低。因此，Fut-175似乎是重症急性胰腺炎中蛋白酶介导的高凝和纤溶的有效抑制剂。
