Plusczyk T, Rathgeb D, Westermann S, Feifel G
Department of General Surgery and Institute for Clinical & Experimental Surgery, University of Saarland, Homburg/Saar, Germany.
Dig Dis Sci. 1998 Mar;43(3):575-85. doi: 10.1023/a:1018819326009.
Using in vivo microscopy, red blood cell (RBC) velocities, functional capillary density (FCD), and overall changes in capillary blood flow (PI) were estimated following intraductal infusion of sodium taurocholate (0.8 ml; 4%) alone or in combination with systemic administration of somstostatin (single bolus SMS 100 microg/100 g body wt). Sodium taurocholate mediated a significant transient decrease in RBC velocities and a sustained decrease in FCD, which were paralleled by dramatic flow heterogeneity. Therefore, a significant reduction in overall capillary blood flow was calculated. Additional SMS treatment reduced microcirculatory impairment as expressed by reduction of blood flow heterogeneity, a less rarified functional capillary density, and a recovery of RBC velocities and acinar capillary overall perfusion to control values. As a result of this microcirculatory improvement, pancreas histology revealed slightly less severe tissue damage compared to the non-SMS-treated pancreatitis group. These findings demonstrate that exogenous SMS infusion can improve microcirculatory failure in acute biliary pancreatitis, which should have a beneficial effect on the course of the disease.
采用体内显微镜技术,在经导管单独输注牛磺胆酸钠(0.8 ml;4%)或联合全身注射生长抑素(单次推注SMS 100 μg/100 g体重)后,对红细胞(RBC)速度、功能性毛细血管密度(FCD)以及毛细血管血流的总体变化(PI)进行评估。牛磺胆酸钠介导红细胞速度显著短暂降低以及功能性毛细血管密度持续降低,同时伴有显著的血流异质性。因此,计算得出总体毛细血管血流显著减少。额外的生长抑素治疗减轻了微循环损伤,表现为血流异质性降低、功能性毛细血管密度稀疏程度减轻、红细胞速度恢复以及腺泡毛细血管总体灌注恢复至对照值。由于这种微循环改善,与未接受生长抑素治疗的胰腺炎组相比,胰腺组织学显示组织损伤稍轻。这些发现表明,外源性输注生长抑素可改善急性胆源性胰腺炎的微循环衰竭,这对疾病进程应具有有益作用。