E0029416

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Not Applicable (or Unknown)

ジュウショウ キュウセイ スイエン ニタイスル ケッショウ コウカン リョウホウ ノ イギ ニツイテノ ジッケンテキ ケントウ

Experimental study of the effectiveness of plasma exchange for severe acute pancreatitis

Japanese (日本語)

Medical journal of Kobe University

48(2)

13-20

1987-06

Recently plasma exchange (PE) is being used as so many therapeutic tools. Then, the effectiveness of PE as a new therapeutic trial for severe acute pancreatitis was evaluated experimentally. The experimetal animals used were adult mongrel dogs and models of pancreatitis were prepared by injection of 30% Na-deoxycholate through the main pancreatic duct to induce hemorrhagic necrotizing pancreatitis. In the PE, about 100 ml/kg of canine plasma was removed and an equal volume of canine fresh frozen plasma was substituted. PE was continuously performed for 2 to 3 hrs a day and repeated three times a week under measuring pancreatic enzyme concentration and monitoring circulatory system. Pancreatic enzyme such as amylase, lipase, trypsin, pancreatic secretory trypsin inhibitor (PSTI), trypsin inhibitor capacity (TIC), trypsin protease esterase (TPE), α_1-antitrypsin, (α_1-AT) α_2-macroglobulin (α_2-MG) were serially assayed. Plasma levels of amylase and trypsin markedly increased soon after the onset of pancreatitis and significantly decreased after every PE. On the other hand, plasma levels of α_1-AT and α_2-MG declined during the attack, but were gradually increased almost normal levels with PE. Circulatory system did not change significantly during PE treatment. In conclusion, PE may be useful as therapy in severe acute pancreatitis by the following advantages. 1) It is effective in removing all toxic substances and preventing the impairment of endogenous protease inhibitors. 2) The survival rate in the therapeutic models with the PE showed a statistically significant improvement.

α2-roacroglobulin

紀要論文