Experimental Research Of Lipo-PGE1 For Therapeutic Effect On Mesenteric Venous Thrombosis In A Rabbit Model

Part One : Injecting Thrombase to Establish the Model of Mesenteric Venous Thrombosis in RabbitsObjective To investigate the method and characters of injecting thrombase to establish the model of mesenteric venous thrombosis(MVT) in rabbits. Method We grouped 36 rabbits into 3 units randomly, 12 per group and injected thrombase in mesenteric venous tributary 80u/1ml in group A, 40u/1ml in group B, and made group C to be the comparison group in which 1ml normal saline was used only. The time of thrombogenesis and the variation of D-Dimer in peripheral venous blood were surveyed. Results Both group A and B could establish stabile MVT models. The time of extensive thrombus formation was 15.6±2.0 minutes in group A and 22.3±2.5 minutes in group B separately, and there was significant difference between them (P<0.001). D-Dimer in peripheral venous blood before thrombogenesis was 68.4±5.7ng/ml vs 72.7±6.4ng/ml, and after thrombogenesis was 209.0±24.0ng/ml vs 215.4±17.6ng/ml, and there was no significant difference between the groups (P>0.05), and there was significant difference in each group (P<0.001). No thrombosis occurred in group C which was blocked without injecting thrombase. Conclusion Injecting thrombase with 80u/1ml is a feasible method to establish the model of rabbits with mesenteric vein thrombosis.Part Two: The Effect of Using Lipo-PGE1 on D-dimer Value in Rabbits'Mesenteric Vein ThrombosisObjective To investigate the possibility of using Lipo-PGE1 to treat acute mesenteric vein thrombosis by analyzing the variation of the D-dimer drew from the peripheral vein belongs to the acute rabbit MVT models injected Lipo-PGE1. Method We made 30 rabbits into A, B,C groups equally .Group A and Group B were established as MVT models. The treatment plan of group A was Parnaparin+Lipo-PGE1+5%GNS, group B was Parnaparin+5%GNS. The group C as blank comparison was treated with Parnaparin+5%GNS. Detecting the D-dimer quantitation from the peripheral vein in the model groups at the moments of preoperative, 1h after the the thrombogenesis, and 2h, 4h, 6h after the treatment, named T1-T5 respectively. Observing the modified Chiu's scores and the thrombolysis statement after the experiment. Results The D-dimer results of group A T3-T5 were 247.5±10.5ng/ml,259.1±9.6ng/ml,273.6±11.9 ng/ml separately; while group B T3-T5 were 231.9±14.1 ng/ml,228.7±12.4 ng/ml,224.6±12.6 ng/ml separately. There was no significant difference at the moment of T3 between group A and group B (P>0.05) and had significant difference at the moment of T4 and T5 (P<0.001). The D-dimer quantitation of group C was significantly small than group A and B (P<0.001). The thrombolysis rate and pathologic scores in group A was significantly better than group B (P<0.05). Conclusion Lipo-PGE1 could significantly enhance the thrombolysis activity of the rabbits'MVT models and make the peripheral venous D-dimer quantitation keep rising with time lasting. It has potential therapeutic value to deal with the rabbits'MVT.Part Three: The Effect of Using Lipo-PGE1 Combined Small Dose Urokinase on D-dimer Value in Rabbits'Mesenteric Vein ThrombosisObjective To investigate the treatment value to mesenteric venous thrombosis by analyzing the variation of plasma D-dimer according to use Lipo-PGE1 combined small dose urokinase to treat rabbits'MVT. Method We made 30 rabbits into groupA,B,C randomly and equally, then established the MVT models. Each group received different treatment plan as intervention: parnaparin+lipo-PGE1 for group A; parnaparin+small dose UK+5%G/NS for group B and parnaparin+ small dose UK+lipo-PGE1 for group C. Detecting the peripheral vein plasma D-dimer quantitation 5 times in the model groups seperately at the moment of 1h before operation(T1),1h after the thrombosis formed(T2), and 2h,4h,6h after treated(T3). Observing the modified Chiu's scores and the thrombolysis statement after the experiment. Result The D-dimer quantitation of group A at T3-T5 were 247.5±10.5ng/ml,259.1±9.6ng/ml,273.6±11.9 ng/ml; the same of group B were 305.7±13.8 ng/ml,262.0±7.5 ng/ml,259.0±5.1 ng/ml and group C were 304.4±21.4 ng/ml,345.0±10.4 ng/ml,359.2±10.3 ng/ml. D-dimer quantitation of group C at T4 and T5 were obviously higher than group A and group B, with significant difference exist((P<0.001).In group B, D-dimer was rising rapidly at the moment of 2h after the treatment and smoothly decreasing at the moment of 4h-6h. The therapeutic effect in group A and C, the thrombolysis rate and pathologic scores are better than group B, and there was no significant difference of the thrombolysis rate and pathologic scores among the group A and C(p>0.05). Conclusion Lipo-PGE1 could enhance the thrombolysis activity obviously by using small dose UK to treat rabbit MVT models. The effect was persisting. Long time observation was needed to investigate the effect of thrombolysis rate.Part Four: Using Lipo-PGE1 Combined with Parnaparin to Treat Mesenteric Vein Thrombosis: Case Analysis and Literature ReviewObjective: To investigate the possibility of using Lipo-PGE1 to treat acute mesenteric vein thrombosis in human cases. Method: We analyzed the clinic data of five patient who were diagnosed as acute mesenteric thrombosis and treated with Lipo-PGE1 Combined with Parnaparin from January 2006 to April 2008, and investigated the diagnosis, therapeutic method and prognosis aided with a literature review. Result: Three cases were cured clinically, and two of them was proved as a complete thrombolysis by doppler color ultrasonography, the other one as a partial thrombolysis. Two cases were received laparotomy because of ileus and tumor located in ileocecal junction, and observed no mesenteric venouse thrombosis in operation. Conclusion: Lipo-PGE1 combined with Parnaparin can be used in the treatment of mesenteric venous thrombosis. Advanced evidence must be offered by a multi center prospective and randomized clinic study with great large sample.