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为研究血液流变学在急性出血性坏死性胰腺炎(AHNP)发病机理中的作用,将44条杂种狗分成5组。第Ⅰ、Ⅱ组分别为手术对照组和急性间质性胰胰炎组(两组各有8条狗)。第Ⅲ、Ⅳ、Ⅴ组狗的主管内注入牛磺胆酸钠溶液形成实验性急性出血性坏死性胰腺炎。而第Ⅳ、Ⅴ组分别用低分子右旋糖酐40(DX40)和丹参溶液静脉注入作为治疗。在所有5组中动脉血压和中心静脉压于手术前后均未见显著性改变。第Ⅲ、Ⅳ、Ⅴ组的血清淀粉酶和脂肪酶水平在实验性AHNP形成后明显增高。但在第Ⅳ、Ⅴ组用药物治疗后,此两酶水平迅速降低。用Low Shear-30流变测定仪测定血液流变学改变。所有5组血浆粘度在手术前、后无明显变化。第Ⅰ、Ⅱ组狗全血的红细胞压积(HCT),在0.512秒~(-1)和51.2秒~(-1)下的表观粘度(η0.512,η51.2),红细胞聚集指数(AI),复粘度的粘性分量(η′)和弹性分量(η″)、以及弹性模量(G′)在手术前后均无明显改变。然而,上述这些参数在实验性AHNP形成后的第Ⅲ、Ⅳ、Ⅴ组有明显增高。但在第Ⅳ和Ⅴ组用药物治疗后,这些参数持续下降;而且,第Ⅴ组丹参溶液比第Ⅳ组的DX40对于血液流变学改变有更好的改善作用。结果证明血液流变学异常是AHNP时引起胰腺微循环障碍的重要因素,并且血液流变学异常的纠正能改善出血性坏死性胰腺炎的症状。
To study the role of hemorheology in the pathogenesis of acute hemorrhagic necrotizing pancreatitis (AHNP), 44 hybrid dogs were divided into five groups. Groups I and II were surgery control group and acute interstitial pancreatitis group (8 dogs in each group). Group Ⅲ, Ⅳ, Ⅴ dogs were injected with sodium taurocholate solution into experimental acute hemorrhagic necrotizing pancreatitis. While IV and V groups were treated with low molecular dextran 40 (DX40) and Salvia miltiorrhiza intravenous injection respectively. No significant changes were observed in arterial blood pressure and central venous pressure in all 5 groups before and after surgery. The levels of serum amylase and lipase in groups Ⅲ, Ⅳ and Ⅴ were significantly higher after the formation of experimental AHNP. However, after treatment with drugs in groups IV and V, the levels of these two enzymes rapidly decreased. Hemorheological changes were measured using a Low Shear-30 rheometer. All 5 groups of plasma viscosity before surgery, no significant change. The hematocrit (HCT) in whole blood of dogs in groups Ⅰ and Ⅱ, the apparent viscosity (η0.512, η51.2) at 0.512 seconds and 51.2 seconds (-1), the erythrocyte aggregation index (AI), viscous component (η ’) and elastic component (η ") and elastic modulus (G’) of the complex viscosity before and after the surgery.However, these parameters in the experimental AHNP after the formation of the first Ⅲ, Ⅳ, Ⅴ group was significantly higher, but in group Ⅳ and Ⅴ treatment with drugs, these parameters continued to decline; and group Ⅴ danshen solution than the group Ⅳ DX40 for hemorheological changes better Improve the results.The results show that abnormal hemorheology is AHNP induced microcirculation of the pancreas an important factor in the disorder, and hemorheology corrected abnormalities can improve the symptoms of hemorrhagic necrotizing pancreatitis.