Research & Development Division, Medical Affairs Section, KM Biologics Co., Ltd., Kumamoto, Japan.
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan.
Sci Rep. 2022 Apr 28;12(1):6986. doi: 10.1038/s41598-022-10968-5.
Combined use of fibrin glue and polyglycolic acid (PGA) sheets has attracted attention as a preventive measure for complications associated with endoscopic submucosal dissection. However, fibrin glue is a protein that may be dissolved by gastric acid. We evaluated the effect of artificial gastric acid on fibrin clot. The dissolution time of three layers of fibrin glue with PGA sheets was measured in five groups (pH 1.2, 2.0, 4.0, 5.5, and 6.0 with pepsin). Measurements of three samples per group were made. The mean number of the remaining layers at each measurement point was observed for 168 h. The time to complete dissolution of the three layers of fibrin gel in the three samples was 2.5 h at pH 1.2, 5 h at pH 2.0, 24 h at pH 4.0, and 48 h and 6 h at pH 5.5. In order to maintain fibrin glue in the stomach for a long period, there was a need to avoid pepsin activation secondary to acidification of gastric juice. The use of strong antacids is recommended.
纤维蛋白胶联合聚乙二醇酸（PGA）片作为预防内镜黏膜下剥离术相关并发症的措施已引起关注。然而，纤维蛋白胶是一种可能被胃酸溶解的蛋白质。我们评估了人工胃酸对纤维蛋白凝块的影响。在五个组（含胃蛋白酶的 pH 值 1.2、2.0、4.0、5.5 和 6.0）中测量了三层纤维蛋白胶和 PGA 片的溶解时间。每组测量三个样本。观察了每个测量点剩余层的平均数量，共 168 小时。在 pH 值为 1.2 时，三个样本中三层纤维蛋白凝胶完全溶解需要 2.5 小时，在 pH 值为 2.0 时需要 5 小时，在 pH 值为 4.0 时需要 24 小时，在 pH 值为 5.5 时需要 48 小时和 6 小时。为了使纤维蛋白胶在胃内长时间保持，需要避免胃酸酸化引起的胃蛋白酶激活。建议使用强抗酸剂。
