Dogs With Severe Acute Pancreatitis Microcirculation Mechanism Experiment Of Compound Danshen Injection Intervention Study

Background Severe acute pancreatitis(SAP) is a common and potentially fatal disease,the the pathogenesis have been incompletely recognised. Nowaday ,there are four hypotheses about pathogenesis of SAP, which were pancreatic enzyme itself degisting, pancreatic microcirculatory disorder, leukocyte activating overly and intestinal bacterial translocation. However much clinical and experimental evidence suggests that pancreatic ischaemia in the earlier period of acute pancreatitis was important in the development of pancreatic hemorrhage and necrosis. While depletion of intravascular volume has often been assumed to be the main circulatory defect, an additional disturbance of pancreatic microcirculation has been demonstrated experimentally. Possible contributory mechanisms include chemical-induced vasoconstriction, direct injury of vessel wall, intravascular coagulation and increased endothelial permeability resulting in pancreatic oedema, haemoeoncentration and impaired venous drainage. Pancreatic ischaemia as a consequence of these local effects was seemed to be responsible for the conversion from pancreatic edema to parenchymal necrosis. In experimental models the beneficial effect of various drugs and of sympathetic blockade has been ascribed to improve pancreatic perfusion. Although effective volume therapy is generally accepted as the mainstay of conservative treatment in acute pancreatitis, the efficacy of different fluid preparations is still controversial, and simple fluid resuscitation has not been shown to prevent the development of parenchymal necrosis. The specific impairment of pancreatic microcirculation cannot be prevented merely by replenishment of intravascular volume with crystalloids, albumin or plasma despite normalization of macrohaemodynamics. In contrast partial replacement of blood by dextran preparations has been shown to increase pancreatic perfusion by improving blood fluidity. Isovolaemic haemodilution in conjunction with conventional .fluid therapy real provide a new and effective means of protecting the pancreas from secondary injury due to the early ischaemic phase of acute pancreatitis.Pancreatic microcirculatory disorders have been deemed to being a first,durative and aggravative injuring factor. Methods In order to study the mechanisms of microcirculatory disorder in dogs with severe acute pancreatitis (SAP) and the intervener of Tanshin(TS), Seventeen dogs were selected and divided randomly into three groups: including normal control group (NC,n~5),severe acute pancreatitis group(SAP,~6) and TS group(TS,n6). SAP models were established by injecting 5% sodium taurocholate(NaTc) and trypsin into the main pancreatic duct under the surgery. The dogs of TS group were intravenously injected TS(2ml/Kg )at 15 minutins and 12 hours respectively after severe acute pancreatitis induction.The changes of indexes that are hemorrheologic parameters, PAF , thromboxane A2(TXA2), prostaglandin 12(PGI2), endothelin (ET) and nitric oxide (NO) were dynamically determined after operations. One of the aims of this study was to identify cell types and distributing within the pancreas expressing the PAF-R using immunohistochemical and in situ hybridization histochemistry protocols Results 1. The level of serum amylase in SAP group increased more significantly than NC and TS groups(P