Leonhardt U, Seidensticker F, Fussek M, Stöckmann F, Creutzfeldt W
Department of Medicine, University of Göttingen, Germany.
Gut. 1990 Aug;31(8):934-7. doi: 10.1136/gut.31.8.934.
The effect of peritoneal lavage with the addition of camostate to the lavage fluid on the outcome of taurocholate pancreatitis in rats was studied. Camostate is a low molecular weight protease inhibitor which has been developed recently. Peritoneal lavage was performed for 12 hours and camostate was added to the lavage fluid in five concentrations. At 0.1 mg/ml the survival rate increased significantly (11 of 20 v controls 4 of 20, p less than 0.05); the maximal effect was observed at 0.2 mg/ml, and no effect was seen at 0.01 and 0.05 mg/ml. Adverse effects occurred at 0.5 mg/ml. The addition of 0.1 mg/ml camostate significantly reduced the acidosis in arterial blood: mean (SD) pH 7.30 (0.035) v controls 7.23 (0.054) (n = 9, p less than 0.01) and arterial base excess: -15.4 (1.26) mmol/l v controls: -17.4 (2.51) mmol/l (n = 9, p less than 0.05). There was no difference, however, in plasma amylase activity and in the histological degree of specific tissue damage to the pancreas. A combination of intravenous camostate and lavage with the addition of camostate to the lavage fluid yielded a significantly improved survival compared with treatment with intravenous camostate alone (10 out of 16 animals v intravenous camostate alone, two out of 16, p greater than 0.01). We conclude that lavage with camostate significantly improves the prognosis of severe necrotising pancreatitis in rats.
研究了在大鼠牛磺胆酸盐胰腺炎中,向灌洗液中添加抑肽酶进行腹腔灌洗对其预后的影响。抑肽酶是一种最近研制出的低分子量蛋白酶抑制剂。进行了12小时的腹腔灌洗,并向灌洗液中添加了五种浓度的抑肽酶。在0.1mg/ml时,存活率显著提高(20只中有11只存活,对照组20只中有4只存活,p<0.05);在0.2mg/ml时观察到最大效果,而在0.01mg/ml和0.05mg/ml时未观察到效果。在0.5mg/ml时出现了不良反应。添加0.1mg/ml抑肽酶可显著减轻动脉血酸中毒:平均(标准差)pH值7.30(0.035),对照组为7.23(0.054)(n=9,p<0.01),动脉碱剩余为-15.4(1.26)mmol/L,对照组为-17.4(2.51)mmol/L(n=9,p<0.05)。然而,血浆淀粉酶活性和胰腺特定组织损伤的组织学程度并无差异。与单独静脉注射抑肽酶相比,静脉注射抑肽酶并在灌洗液中添加抑肽酶联合治疗可显著提高存活率(16只动物中有10只存活,单独静脉注射抑肽酶组16只中有2只存活,p>0.01)。我们得出结论,用抑肽酶灌洗可显著改善大鼠重症坏死性胰腺炎的预后。