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目的观察前列腺素E1(PGE1)对急性坏死型胰腺炎犬的作用,并探讨其对重症急性胰腺炎 (SAP)患者的治疗效果。方法制备急性坏死型胰腺炎犬模型,并用PGE1进行干预,测定胰背动脉和肠系膜上动脉血流量及血清淀粉酶活性,观察病理组织学改变。采用前瞻性、对照、开放试验,将确诊为 SAP的患者分为PGE1治疗组和丹参对照组,检测血清淀粉酶、乳酸脱氢酶、血清C-反应蛋白,并进行 APACHEⅡ评分、SIRS评分、Binder合并症评分和CT评分。结果 PGE1可提高胰腺组织血液流量,明显减少胰腺组织的损伤和炎症反应。PGE1治疗组较丹参对照组血清淀粉酶恢复正常时间缩短。PGE1脂微球较丹参在不同时间点能更明显改善APACHEⅡ评分、SIRS评分、CT评分。结论 PGE1对重症急性胰腺炎具有一定的治疗作用。
Objective To investigate the effect of prostaglandin E1 (PGE1) on acute necrotic pancreatitis in dogs and its therapeutic effect on patients with severe acute pancreatitis (SAP). Methods Acute necrotic pancreatitis model was made in dogs. PGE1 was used as the intervention to measure the blood flow of pancreatic dorsal artery and superior mesenteric artery and the serum amylase activity. Pathological changes were observed. A prospective, controlled and open trial was conducted. Patients diagnosed with SAP were divided into PGE1 treatment group and Salvia miltiorrhiza control group. Serum amylase, lactate dehydrogenase and serum C-reactive protein were detected and APACHEⅡscore, SIRS score, Binder Comorbidity and CT scores. Results PGE1 could improve the blood flow of pancreatic tissue and significantly reduce the damage and inflammatory reaction of pancreatic tissue. PGE1 treatment group than Salvia control serum amylase recovery time is shortened. Compared with Danshen, PGE1 lipid microspheres could improve APACHEⅡscore, SIRS score and CT score at different time points. Conclusion PGE1 has a certain therapeutic effect on severe acute pancreatitis.