Hać D S, Mionskowska L, Dobrowolski S, Dymecki D, Makarewicz W, Wajda Z
II Katedry i Kliniki Chirurgii Ogólnej, Gastroenterologicznej i Endokrynologicznej Akademii Medycznej w Gdańsku.
Wiad Lek. 1997;50 Suppl 1 Pt 2:108-14.
Microcirculatory disturbance may play an important role in the development of severe pancreatitis, leading the edematous form of the disease to the necrosis. The aim of this study was to investigate the impact of L-arginine (nitric oxide donor), L-NN (NO synthase inhibitor), and heparin on the pancreas microcirculation, serum interleukin-6 level and microscopic alterations of the pancreas in acute pancreatitis in rats.
Acute pancreatitis was induced in 72 rats by four intraperitoneal injections of cerulein (CN) (15 micrograms/kg body weight). Microcirculatory values was measured by means of laser Doppler flowmetry five hours after the first cerulein injection. The animals were divided into the following groups (12 rats each), according to the kind of treatment: Group 1 (CN), Group 2 (CN + L-NNA), Group 3 (CN + L-arginine), Group 4 (CN + Heparin), Group 5 (Control), Group 6 (L-NNA), Group 7 (L-arginine), Group 8 (Heparin).
Remarkable morphologic changes in the pancreas including parenchymal necrosis, an elevation of serum IL-6 level, and significant drop of pancreatic capillary perfusion was observed in rats with NO synthase inhibition. L-arginine improved the pancreatic microcirculatory but worsened the microscopic alteration within the pancreas. Heparin had a beneficial effect on the microcirculatory values, serum IL-6 concentration, and morphologic changes.
Acute pancreatitis causes microcirculatory disturbance within the pancreatic gland. The inhibition of NO synthase aggravates AP. L-arginine treatment improves pancreatic perfusion but potentiates morphologic alterations. Heparin has beneficial impact on AP, it improves the microcirculation and inflammatory changes within the pancreatic gland.
微循环障碍可能在重症胰腺炎的发展中起重要作用,导致疾病的水肿形式转变为坏死。本研究的目的是探讨L-精氨酸(一氧化氮供体)、L-NNA(一氧化氮合酶抑制剂)和肝素对大鼠急性胰腺炎胰腺微循环、血清白细胞介素-6水平及胰腺微观改变的影响。
通过腹腔注射四次雨蛙素(CN)(15微克/千克体重)诱导72只大鼠发生急性胰腺炎。在首次注射雨蛙素后5小时,用激光多普勒血流仪测量微循环值。根据治疗类型将动物分为以下几组(每组12只大鼠):第1组(CN)、第2组(CN + L-NNA)、第3组(CN + L-精氨酸)、第4组(CN +肝素)、第5组(对照组)、第6组(L-NNA)、第7组(L-精氨酸)、第8组(肝素)。
在一氧化氮合酶抑制的大鼠中观察到胰腺显著的形态学变化,包括实质坏死、血清IL-6水平升高以及胰腺毛细血管灌注显著下降。L-精氨酸改善了胰腺微循环,但加重了胰腺内的微观改变。肝素对微循环值、血清IL-6浓度和形态学变化有有益影响。
急性胰腺炎导致胰腺内微循环障碍。一氧化氮合酶的抑制会加重急性胰腺炎(AP)。L-精氨酸治疗可改善胰腺灌注,但会加剧形态学改变。肝素对急性胰腺炎有有益影响,它可改善胰腺内的微循环和炎症变化。