摘要目的 观察巴曲酶对改善重症急性胰腺炎(SAP)微循环障碍的作用.方法 将38例SAP患者按照平行对照设计原理随机分为A组(21例)和B组(17例),同时以健康志愿者18例作为对照组.A组采用常规治疗,B组采用常规治疗+巴曲酶治疗,以放射免疫法测定血浆内皮素(ET)、血栓素B_2(TXB_2)、6-酮-前列腺素F_(1α)(6-keto-PGF_(1α))浓度及TXB_2/6-keto-PGF_(1α)测定A、B两组胰腺Bahhazar CT分级评分及急性生理和慢性健康状况(APACHE)Ⅱ评分.结果 血浆6-keto-PGF_(1α)浓度,B组入院第6天[(129.3±12.9)ng/L]与入院时[(98.9±10.7)ng/L]及A组入院第6天[(108.2±11.6)ng/L]比较,均显著上升(P<0.05),而血浆ET、TXB_2浓度及TXB_2/6-keto-PGF_(1α),B组入院第6天[分别为(93.8±9.9)ng/L、(254.4±24.9)ng/L、1.83±0.31]与入院时[分别为(140.3±13.1)ng/L、(311.4±31.5)ng/L、3.16±0.54]及A组入院第6天[分别为(120.3±11.4)ng/L、(308.5±31.1)ng/L、2.84±0.43]比较,均显著下降(P<0.05).胰腺BalthazarCT分级评分和APACHE Ⅱ评分,B组入院第6天与入院时及A组入院第6天比较,均显著降低(P<0.05或<0.01).结论 巴曲酶能较好地改善SAP微循环障碍.

abstractsObjective To explore the effects of batroxobin on the microcirculation of patients with severe acute pancreatitis (SAP). Methods A total of 38 patients with SAP were randomly divided into group A (21 cases) and group B (17 cases). Patients in group A were treated with routine method andpatients in greup B were treated with routine method plus batroxobin injection. Another 18 normal individuals were used as control. The levels of plasma endothelin (ET), thromboxane B_2 (TXB_2) and 6-keto-PGF_(1α)were measured by radioimmunoassay. At the same time, the ratio of TXB_2/6-keto-PGF_(1α) was observed. The Balthazar CT and APACHE Ⅱ scores were monitored and compared between group A and group B. Results The levels of plasma 6-keto-PGF_(1α) were significantly higher while the levels of plasma ET, TXB_2 and the ratio of TXB_2/6-keto-PGF_(1α) were significantly lower in group B at 6 days after admission [(129.3 ± 12.9) ng/L, (93.8 ± 9.9) ng/L, (254.4 ± 24.9) ng/L and 1.83 ± 0.31]as compared with those in group B on admission [(98.9 ± 10.7) ng/L, (140.3 ± 13.1) ng/L, (311.4 ± 31.5) ng/L and 3.16 ± 0.54]and group A at 6 days after admission [(108.2 ± 11.6) ng/L, (120.3 ± 11.4) ng/L, (308.5 ± 31.1) ng/L and 2.84 ± 0.43](P < 0.05). The Balthazar CT and APACHE Ⅱ scores in group B at 6 days after admission were significantly lower than those in group B on admission and group A at 6 days after admission (P< 0.05 or < 0.01). Conclusion Batroxobin is an effective way to improve the microcirculation in SAP.