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Rumbus Z, Toth E, Poto L, Vincze A, Veres G, Czako L, Olah E, Marta K, Miko A, Rakonczay Z, Balla Z, Kaszaki J, Foldesi I, Maleth J, Hegyi P, Garami A. Bidirectional Relationship Between Reduced Blood pH and Acute Pancreatitis: A Translational Study of Their Noxious Combination. Front Physiol 2018; 9:1360. [PMID: 30327613 PMCID: PMC6174522 DOI: 10.3389/fphys.2018.01360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022] Open
Abstract
Acute pancreatitis (AP) is often accompanied by alterations in the acid-base balance, but how blood pH influences the outcome of AP is largely unknown. We studied the association between blood pH and the outcome of AP with meta-analysis of clinical trials, and aimed to discover the causative relationship between blood pH and AP in animal models. PubMed, EMBASE, and Cochrane Controlled Trials Registry databases were searched from inception to January 2017. Human studies reporting systemic pH status and outcomes (mortality rate, severity scores, and length of hospital stay) of patient groups with AP were included in the analyses. We developed a new mouse model of chronic metabolic acidosis (MA) and induced mild or severe AP in the mice. Besides laboratory blood testing, the extent of pancreatic edema, necrosis, and leukocyte infiltration were assessed in tissue sections of the mice. Thirteen studies reported sufficient data in patient groups with AP (n = 2,311). Meta-analysis revealed markedly higher mortality, elevated severity scores, and longer hospital stay in AP patients with lower blood pH or base excess (P < 0.001 for all studied outcomes). Meta-regression analysis showed significant negative correlation between blood pH and mortality in severe AP. In our mouse model, pre-existing MA deteriorated the pancreatic damage in mild and severe AP and, vice versa, severe AP further decreased the blood pH of mice with MA. In conclusion, MA worsens the outcome of AP, while severe AP augments the decrease of blood pH. The discovery of this vicious metabolic cycle opens up new therapeutic possibilities in AP.
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Affiliation(s)
- Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Emese Toth
- Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary.,First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Laszlo Poto
- Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary
| | - Aron Vincze
- Department of Gastroenterology, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Gabor Veres
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Laszlo Czako
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Emoke Olah
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Katalin Marta
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Alexandra Miko
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Zoltan Rakonczay
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Zsolt Balla
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Jozsef Kaszaki
- Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Imre Foldesi
- Department of Laboratory Medicine, University of Szeged, Szeged, Hungary
| | - Jozsef Maleth
- First Department of Medicine, University of Szeged, Szeged, Hungary.,Momentum Epithel Cell Signaling and Secretion Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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Windisch O, Heidegger CP, Giraud R, Morel P, Bühler L. Thoracic epidural analgesia: a new approach for the treatment of acute pancreatitis? Crit Care 2016; 20:116. [PMID: 27141977 PMCID: PMC4855315 DOI: 10.1186/s13054-016-1292-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This review article analyzes, through a nonsystematic approach, the pathophysiology of acute pancreatitis (AP) with a focus on the effects of thoracic epidural analgesia (TEA) on the disease. The benefit-risk balance is also discussed. AP has an overall mortality of 1 %, increasing to 30 % in its severe form. The systemic inflammation induces a strong activation of the sympathetic system, with a decrease in the blood flow supply to the gastrointestinal system that can lead to the development of pancreatic necrosis. The current treatment for severe AP is symptomatic and tries to correct the systemic inflammatory response syndrome or the multiorgan dysfunction. Besides the removal of gallstones in biliary pancreatitis, no satisfactory causal treatment exists. TEA is widely used, mainly for its analgesic effect. TEA also induces a targeted sympathectomy in the anesthetized region, which results in splanchnic vasodilatation and an improvement in local microcirculation. Increasing evidence shows benefits of TEA in animal AP: improved splanchnic and pancreatic perfusion, improved pancreatic microcirculation, reduced liver damage, and significantly reduced mortality. Until now, only few clinical studies have been performed on the use of TEA during AP with few available data regarding the effect of TEA on the splanchnic perfusion. Increasing evidence suggests that TEA is a safe procedure and could appear as a new treatment approach for human AP, based on the significant benefits observed in animal studies and safety of use for human. Further clinical studies are required to confirm the clinical benefits observed in animal studies.
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Affiliation(s)
- Olivier Windisch
- />Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | | | - Raphaël Giraud
- />Division of Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Morel
- />Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Léo Bühler
- />Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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Munhoz-Filho CH, Batigália F, Funes HLX. Clinical and therapeutic correlations in patients with slight acute pancreatitis. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2016; 28:24-7. [PMID: 25861064 PMCID: PMC4739250 DOI: 10.1590/s0102-67202015000100007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/08/2015] [Indexed: 01/31/2023]
Abstract
Background Acute pancreatitis is an inflammatory disease of the pancreas due to enzymatic
autodigestion which can cause necrosis or multiple organ failure; its
pathophysiology is not fully known yet. Aim To evaluate the correlation between clinical and therapeutic data in patients with
mild acute pancreatitis. Methods A retrospective study in 55 medical records of patients admitted with acute mild
pancreatitis was realized to analyze the association between age, leukocytosis,
serum glutamic-oxaloacetic transaminase and lactate dehydrogenase, glucose,
antibiotics, time admission and Ranson´s scores. Results There was a positive association between less intensive care (strict hydration,
analgesia and monitoring of vital signs), early antibiotic therapy (monotherapy),
early return to diet after 48 hours and laboratory control of the serum amylase
and lipase (high in the first week and decreasing after 10 days, without any
prognostic value). Conclusions Changes in the management of patients with mild acute pancreatitis, such as
enteral nutrition, rational use of lower spectrum antibiotics and intensive care,
have contributed significantly to the reduction of hospitalization time and
mortality.
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Affiliation(s)
- Clewis Henri Munhoz-Filho
- Department of Anatomy, São José do Rio Preto Medical School, São José do Rio Preto, São Paulo, Brazil
| | - Fernando Batigália
- Department of Anatomy, São José do Rio Preto Medical School, São José do Rio Preto, São Paulo, Brazil
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Enteral nutrition within 72 h after onset of acute pancreatitis vs delayed initiation. Eur J Clin Nutr 2014; 68:1288-93. [DOI: 10.1038/ejcn.2014.164] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 06/30/2014] [Accepted: 07/14/2014] [Indexed: 02/06/2023]
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Sharma V, Shanti Devi T, Sharma R, Chhabra P, Gupta R, Rana SS, Bhasin DK. Arterial pH, bicarbonate levels and base deficit at presentation as markers of predicting mortality in acute pancreatitis: a single-centre prospective study. Gastroenterol Rep (Oxf) 2014; 2:226-31. [PMID: 24994834 PMCID: PMC4124274 DOI: 10.1093/gastro/gou037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background. Arterial blood gas (ABG) parameters such as pH form part of multi-parameter scoring systems for predicting severe acute pancreatitis; however, literature on detailed evaluation of ABG alone in this context is scarce. Methods. Patients with acute pancreatitis presenting to our unit between January 2012 and November 2013 were prospectively studied. ABG analysis was done at admission and development of organ failure, any need for intervention, and mortality were noted. The association between various parameters of ABG analysis and the development of organ failure or local complications, need for interventions (endoscopic/radiological/surgical) and mortality were analysed. Results. Two hundred and five patients (mean age: 39.33 ± 13.85 years; 61.0% males) were prospectively studied. The aetiology of acute pancreatitis was alcohol in 93 patients (45.4%) and gall stone disease in 73 (35.6%). Organ failure developed in 71.2% patients and 83.9% had local complications. In 18% of patients, endoscopic/radiological/surgical interventions were needed and 14.6% died. The patients (n = 35) with metabolic acidosis (pH <7.35) suffered higher frequency of organ failure, need for interventions and mortality. Patients with low arterial bicarbonate levels, as well as higher base deficit, also displayed higher frequency of organ failure, need for interventions and mortality. The receiver operating characteristic (ROC) curves for pH <7.35, bicarbonate <22 meq/L and base deficit of >−4 meq/L for prediction of mortality were 0.771 (95% CI: 0.664–0.878), 0.707 (95% CI: 0.622–0.791) and 0.780 (95% CI: 0.693–0.867), respectively. Conclusion. Arterial pH, bicarbonate levels, and base deficit at presentation are useful early markers for predicting adverse outcome in acute pancreatitis.
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Affiliation(s)
- Vishal Sharma
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Thingbaijam Shanti Devi
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravi Sharma
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Puneet Chhabra
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajesh Gupta
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder S Rana
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak K Bhasin
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Early enteral nutrition prevents intra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition: a prospective pilot study. World J Surg 2014; 37:2053-60. [PMID: 23674254 DOI: 10.1007/s00268-013-2087-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND To investigate the effects of early enteral nutrition (EEN) on intra-abdominal pressure (IAP) and disease severity in patients with severe acute pancreatitis (SAP). METHODS Enteral nutrition (EN) was started within 48 h after admission in the EEN group and from the 8th day in the delayed enteral nutrition (DEN) group. The IAP and intra-abdominal hypertension (IAH) incidence were recorded for 2 weeks. The caloric intake and feeding intolerance (FI) incidence were recorded daily after EN was started. The severity markers and clinical outcome variables were also recorded. RESULTS Sixty patients were enrolled to this study. No difference about IAP was found. The IAH incidence of the EEN group was significantly lower than that of the DEN group from the 9th day (8/30 versus 18/30; P = 0.009) after admission. The FI incidence of the EEN group was higher than that of the DEN group during the initial 3 days of feeding (25/30 versus 12/30; P = 0.001; 22/30 versus 9/30; P = 0.001; 15/30 versus 4/30; P = 0.002). Patients with an IAP <15 mmHg had lower FI incidence than those with an IAP ≥15 mmHg on the 1st day (20/22 versus 17/38; P < 0.001), the 3rd day (11/13 versus 8/47; P < 0.001), and the 7th day (3/5 versus 3/55; P = 0.005) of feeding. The severity markers and clinical outcome variables of the EEN group were significantly improved. CONCLUSIONS Early enteral nutrition did not increase IAP. In contrast, it might prevent the development of IAH. In addition, EEN might be not appropriate during the initial 3-4 days of SAP onset. Moreover, EN might be of benefit to patients with an IAP <15 mmHg. Early enteral nutrition could improve disease severity and clinical outcome, but did not decrease mortality of SAP.
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Sun JJ, Chu ZJ, Liu WF, Qi SF, Yang YH, Ge PL, Zhang XH, Li WS, Yang C, Zhang YM. Perirenal space blocking restores gastrointestinal function in patients with severe acute pancreatitis. World J Gastroenterol 2013; 19:8752-8757. [PMID: 24379596 PMCID: PMC3870524 DOI: 10.3748/wjg.v19.i46.8752] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 11/05/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate effects of perirenal space blocking (PSB) on gastrointestinal function in patients with severe acute pancreatitis (SAP).
METHODS: Forty patients with SAP were randomly allocated to receive PSB or no PSB (NPSB). All the SAP patients received specialized medical therapy (SMT). Patients in the PSB group received PSB + SMT when hospitalized and after diagnosis, whereas patients in the NPSB group only received SMT. A modified gastrointestinal failure (GIF) scoring system was used to assess the gastrointestinal function in SAP patients after admission. Pain severity (visual analog scale, 0 to 100) was monitored every 24 h for 72 h.
RESULTS: Modified GIF score decreased in both groups during the 10-d study period. The median score decrease was initially significantly greater in the PSB group than in the NPSB group after PSB was performed. During the 72-h study period, pain intensity decreased in both groups. The median pain decrease was significantly greater in the PSB group than in the NPSB group at single time points. Patients in the PSB group had significantly lower incidences of hospital mortality, multiple organ dysfunction syndrome, systemic inflammatory response syndrome, and pancreatic infection, and stayed in the intensive care unit for a shorter duration. However, no difference in terms of operation incidence was found between the two groups.
CONCLUSION: PSB could ameliorate gastrointestinal dysfunction or failure during the early stage of SAP. Moreover, PSB administration could improve prognosis and decrease the mortality of SAP patients.
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Sun JK, Mu XW, Li WQ, Tong ZH, Li J, Zheng SY. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol 2013; 19:917-922. [PMID: 23431120 PMCID: PMC3574890 DOI: 10.3748/wjg.v19.i6.917] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 11/02/2012] [Accepted: 12/18/2012] [Indexed: 02/07/2023] Open
Abstract
AIM: To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).
METHODS: Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN). Enteral nutrition was started within 48 h after admission in EEN group, whereas from the 8th day in DEN group. All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1, 3, 7 and 14 after admission. The clinical outcome variables were also recorded.
RESULTS: Sixty SAP patients were enrolled to this study. The CD4+ T-lymphocyte percentage, CD4+/CD8+ ratio, and the CRP levels in EEN group became significantly lower than in DEN group from the 7th day after admission. In contrast, the immunoglobulin G (IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7th day after admission. No difference of CD8+ T-lymphocyte percentage, IgM and IgA levels was found between the two groups. The incidences of multiple organ dysfunction syndrome, systemic inflammatory response syndrome, and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group. However, there was no difference of hospital mortality between the two groups.
CONCLUSION: EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression. EEN can improve the clinical outcome, but not decrease the hospital mortality of SAP patients.
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Sun JK, Li WQ, Ni HB, Ke L, Tong ZH, Li N, Li JS. Modified gastrointestinal failure score for patients with severe acute pancreatitis. Surg Today 2013; 43:506-13. [PMID: 23361596 DOI: 10.1007/s00595-013-0496-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Accepted: 02/13/2012] [Indexed: 01/14/2023]
Abstract
PURPOSE No consensus has been reached to define gastrointestinal failure (GIF) associated with severe acute pancreatitis (SAP). Reintam and colleagues proposed a scoring system of GIF for critically ill patients, but its suitability for patients with SAP is questionable. The present study evaluates a modified GIF score we developed to assess the GIF of patients with SAP. METHODS The subjects of this study were 52 patients with SAP treated between September 2010 and July 2011. We recorded the Reintam's GIF score, our modified GIF score, the acute physiology and chronic health evaluation (APACHE) II score, the sequential organ failure assessment (SOFA) score, and other clinical values during the first 3 days after admission. The prognostic value of the modified GIF score, for evaluating the severity and outcomes of SAP, was also assessed. RESULTS Compared with the Reintam's GIF score, the modified GIF score seemed to be more valuable for predicting hospital mortality (the area under curve, AUC 0.915 vs. 0.850), multiple organ dysfunction syndrome (MODS) (AUC 0.829 vs. 0.766), and pancreatic infection (AUC 0.796 vs. 0.776). Moreover, combining the modified GIF score and the SOFA or APACHEII scores resulted in more accurate prediction of the prognosis of SAP than either score alone. CONCLUSION The modified GIF score is useful for assessing gastrointestinal system function, which may serve as an early prognostic tool to evaluate the severity and predict the outcomes of SAP.
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Affiliation(s)
- Jia-Kui Sun
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 210006 Nanjing, Jiangsu Province, China
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Apodaca-Torrez FR, Lobo EJ, Monteiro LMC, Melo GRD, Goldenberg A, Herani Filho B, Triviño T, Lopes Filho GDJ. Resultados do tratamento da pancreatite aguda grave. Rev Col Bras Cir 2012; 39:385-8. [DOI: 10.1590/s0100-69912012000500008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/06/2012] [Indexed: 12/15/2022] Open
Abstract
OBJETIVO: Avaliar os resultados do Protocolo de Atendimento de pacientes com diagnóstico de pancreatite aguda grave. MÉTODOS: Foram analisados, consecutivamente, a partir de janeiro de 2002, idade, sexo, etiologia, tempo de internação, tipo de tratamento e mortalidade de 37 pacientes portadores de pancreatite aguda grave. RESULTADOS: A idade dos pacientes variou de 20 a 88 anos (média de 50 anos); 27% foram do sexo feminino e 73% do masculino. O tempo médio global de internação foi 47 dias. Treze pacientes foram tratados cirurgicamente; a média de operações realizadas foi duas por paciente. Ocorreram seis óbitos dentre os pacientes submetidos ao tratamento cirúrgico (46%) e dois óbitos no grupo submetido somente ao tratamento clínico (8,3%). A mortalidade global foi 21% CONCLUSÃO: Após a modificação na forma de abordagem dos pacientes com pancreatite aguda grave, houve diminuição da mortalidade e uma tendência para a conduta expectante.
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Zhang XP, Jiang J, Cheng QH, Ye Q, Li WJ, Zhu H, Shen JY. Protective effects of Ligustrazine, Kakonein and Panax Notoginsenoside on the small intestine and immune organs of rats with severe acute pancreatitis. Hepatobiliary Pancreat Dis Int 2011; 10:632-7. [PMID: 22146628 DOI: 10.1016/s1499-3872(11)60107-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Severe acute pancreatitis (SAP) is characterized by fatal pathogenic conditions and a high mortality. It is important to study SAP complicated with multiple organ injury. In this study we compared the protective effects of three traditional Chinese medicines (Ligustrazine, Kakonein and Panax Notoginsenoside) on the small intestine and immune organs (thymus, spleen and lymph nodes) of rats with SAP and explored their mechanism of action. METHODS One hundred forty-four rats with SAP were randomly divided into model control, Ligustrazine-treated, Kakonein-treated, and Panax Notoginsenoside-treated groups (n=36 per group). Another 36 normal rats comprised the sham-operated group. According to the different time points after operation, the experimental rats in each group were subdivided into 3-, 6- and 12-hour subgroups (n=12). At various time points after operation, the mortality rate of rats and pathological changes in the small intestine and immune organs were recorded and the serum amylase levels were measured. RESULTS Compared to the model control groups, the mortality rates in all treated groups declined and the pathological changes in the small intestine and immune tissues were relieved to different degrees. The serum amylase levels in the three treated groups were significantly lower than those in the model control group at 12 hours. The pathological severity scores for the small intestinal mucosa, thymus and spleen (at 3 and 12 hours) in the Ligustrazine-treated group, for the thymus (at 3 and 12 hours) and spleen (at 3 and 6 hours) in the Kakonein-treated group, and for the thymus (at 3 hours) and spleen (at 3 hours) in the Panax Notoginsenoside-treated group were significantly lower than those in the model control group. The pathological severity scores of the small intestinal mucosa (at 6 and 12 hours) and thymus (at 6 hours) in the Ligustrazine-treated group were significantly lower than those in the Kakonein- and Panax Notoginsenoside-treated groups. CONCLUSIONS All the three traditional Chinese drugs significantly alleviated the pathological changes in the small intestine and immune organs of SAP rats. Ligustrazine was the most effective one among them.
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Affiliation(s)
- Xi-Ping Zhang
- Department of General Surgery, Hangzhou First People's Hospital, Hangzhou 310006, China.
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Matheus AS, Machado MCC. [Severe acute pancreatitis: still a challenge]. ARQUIVOS DE GASTROENTEROLOGIA 2008; 45:179-180. [PMID: 18852941 DOI: 10.1590/s0004-28032008000300001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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