Objective To investigate therapeutic effects of continous regional arterial infusion with verapamil on preventing the progression of acute pancreatitis.
Methods Forty-five patients with mild acute pancreatitis were randomly divided into three groups: conventional treatment group, intravenous treatment group and arterial infusion group. After admission, conventional treatments were performed in conventional treatment group. Reasonable fluid and verapamil were intravenously injected to the patients in intravenous treatment group, and fluid treatments and continous regional arterial infusion with verapamil were performed in arterial infusion group for 1－2 weeks. The levels of serum TNF-α, IL-1β, ICAM-1 and P-selectin were determined on the 1st, 4th and 7th day after treatment, respectively.
Results On the 4th and 7th day after treatment, the levels of serum TNF-α and P-selectin significantly decreased in arterial infusion group compared with the other two groups （P＜0.05）, while the level of serum IL-1β significantly decreased in arterial infusion group and intravenous treatment group compared with the conventional treatment group （P＜0.05）. The level of serum ICAM-1 significantly decreased in arterial infusion group compared with the conventional treatment group （P＜0.05）.
Conclusion Continous regional arterial infusion with verapamil could reduce the production of inflammatory cytokines and inhibit the up-regulation of adhesion molecules ICAM-1 and P-selectin, and prevent the progression of acute pancreatitis ultimately.
Citation：
PU Qingfan,ZHANG Chuanrong,YAN Lnan,CAO Gaojian,PAN Jibao,CAI Yu,JIN Kai. Therapeutic Effects of Continous Regional Arterial Infusion with Verapamil on Progression of Acute Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(2): 200-202. doi:
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- 1. Kahl S, Zimmermann S, Malfertheiner P. Acute pancreatitis: treatment strategies [Ｊ]. Dig Dis， 2003; 21(1)∶ 30.
- 2. Yan LN, Liu XB, Tan JS, et al. Effect of haemorrheological changes in the transition of oedematous pancreatitis to necrosis [Ｊ]. Asian J Surg, 1995; 18(2)∶ 106.
- 3. Takeda K, Mikami Y, Fukuyama S, et al. Pancreatic ischemia associated with vasospasm in the early phase of human acute necrotizing pancreatitis [Ｊ]. Pancreas， 2005; 30(1)∶ 40.
- 4. 蒲青凡， 严律南， 沈骥， 等. 胰腺腺泡细胞钙超负荷在诱发大鼠由水肿性向坏死性胰腺炎转变中的作用 [Ｊ]. 中华医学杂志， 1999； 79（2）∶ 143.
- 5. Klar E, Foitzik T, Buhr H, et al. Isovolemic hemodilution with dextran 60 as treatment of pancreatic ischemia in acute pancreatitis. Clinical practicability of an experimental concept [Ｊ]. Ann Surg， 1993; 217(4)∶ 369.
- 6. 蒲青凡, 严律南, 张川蓉, 等. 阻止急性胰腺炎由轻型向重症发展的非手术治疗172例报告 [Ｊ]. 中华普通外科杂志， 2000; 15(5)∶ 289.
- 7. 蒲青凡, 严律南, 孙碎康， 等. 改善胰腺缺血和钙拮抗剂在急性重症胰腺炎治疗中的保护作用 [Ｊ]. 中国普外基础与临床杂志， 2001； 8（6）∶ 384.
- 8. 蒲青凡, 严律南, 孙碎康， 等. 改善微循环和防止细胞钙超载在阻止急性胰腺炎重症化治疗中的作用 [Ｊ]. 临床外科杂志， 2002； 10（1）∶ 17.
- 9. Lundberg AH, Granger DN, Russell J, et al. Quantitative mea-surement of P- and E-selectin adhesion molecules in acute pancreatitis: correlation with distant organ injury [Ｊ]. Ann Surg， 2000; 231(2)∶ 213.
