AIM: To study the protective effects of tumor necrosis factor α (TNFα) antibody on pancreatic encephalopathy in rats.METHODS: One hundred and twenty SD rats were randomly divided into normal control group, acute nec...AIM: To study the protective effects of tumor necrosis factor α (TNFα) antibody on pancreatic encephalopathy in rats.METHODS: One hundred and twenty SD rats were randomly divided into normal control group, acute necrotizing pancreatitis group and TNFα antibody treated group. Acute hemorrhage necrotizing pancreatitis model in rats was induced by retrograde injection of 50 g/L sodium taurocholate into the pancreatobiliary duct. Serum TNFα was detected and animals were killed 12 h after drug administration. Changes in content of brain water, MDA and SOD as well as leucocyte adhesion of brain microvessels were measured.RESULTS: In TNFα antibody treated group, serum TNFα level was decreased. Content of brain water, MDA and SOD as well as leucocyte adhesion were decreased significantly in comparison with those of acute necrotizing pancreatitis group (P<0.05).CONCLUSION: TNFα antibody can alleviate the brain damage of rats with acute hemorrhage necrotizing pancreatitis.展开更多
目的探讨重症急性胰腺炎(SAP)的治疗原则和方法。方法分析总结我院1992年7月以来98例 SAP 病人的临床表现、手术指征、手术方式、并发症、治疗效果和再次手术等。结果全组98例 SAP 病人(Ⅰ级38例,Ⅱ级60例),治愈83例(84.7%),死亡15例(15...目的探讨重症急性胰腺炎(SAP)的治疗原则和方法。方法分析总结我院1992年7月以来98例 SAP 病人的临床表现、手术指征、手术方式、并发症、治疗效果和再次手术等。结果全组98例 SAP 病人(Ⅰ级38例,Ⅱ级60例),治愈83例(84.7%),死亡15例(15.3%),无并发症51例(52.1%)。其中非手术治疗41例(Ⅱ级11例),治愈37例(90.2%);早期手术治疗15例(Ⅱ级15例),治愈10例(66.7%);中转手术22例(Ⅱ级4例),治愈17例(77.3%);择期手术20例(Ⅱ级4例),治愈19例(95%)。结论治疗 SAP 应在坚持"个体化治疗方案"的原则下,充分重视外科治疗手段在治疗 SAP 中的作用。展开更多
目的:评价入院时Ranson、急性生理学和长期健康评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、Balthazar CT以及胰腺炎结局预测(pancreatitis outcome prediction,POP)评分系统对重症急性胰腺炎(severe acute pa...目的:评价入院时Ranson、急性生理学和长期健康评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、Balthazar CT以及胰腺炎结局预测(pancreatitis outcome prediction,POP)评分系统对重症急性胰腺炎(severe acute pancreatitis,SAP)患者的预后评估价值。方法:回顾性研究了2004年1月～2007年8月在四川大学华西医院住院的253例SAP患者,计算患者入院时Ranson、APACHEⅡ、Balthazar CT和POP的评分分值。观察死亡、胰腺局部并发症、中转手术和多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)发生等4项结局指标。将所有患者的4项评分绘制受试者工作特征(receiver operating characteristic,ROC)曲线,通过计算曲线下面积(area under curve,AUC)来比较各评分系统在判断SAP病情严重度和预后上的敏感性、特异性、Youden指数和阳性似然比(likelihood ratio of positivetest,LRPT)。结果:ROC曲线分析显示Ranson评分可用于预测死亡、中转手术及MODS发生(P=0.00),其诊断阈值均为5。APACHEⅡ评分可以预测胰腺局部并发症以外其他结局指标的发生(P=0.00),APACHEⅡ评分对死亡、中转手术、MODS发生的诊断阈值依次为14、10、12。BalthazarCT评分可预测各项结局指标的发生,诊断阈值均为6。POP评分可预测胰腺局部并发症以外的各项结局指标,其对死亡的预测价值尤为突出,当POP评分≥14时,其预测死亡的敏感性为0.90,特异性为0.92。POP评分对死亡、中转手术、MODS发生的诊断阈值依次为14、8、10。结论:4项评分系统预测能力各有侧重。Ranson、APACHEⅡ和POP评分可以用于疾病的严重程度及全身并发症的预测,对局部并发症的预测效果不佳。POP评分对病死率的预测效果较好;Balthazar CT评分能预测胰腺局部并发症和中转手术的发生及其他结局指标的发生,但敏感性和特异性不高。展开更多
文摘AIM: To study the protective effects of tumor necrosis factor α (TNFα) antibody on pancreatic encephalopathy in rats.METHODS: One hundred and twenty SD rats were randomly divided into normal control group, acute necrotizing pancreatitis group and TNFα antibody treated group. Acute hemorrhage necrotizing pancreatitis model in rats was induced by retrograde injection of 50 g/L sodium taurocholate into the pancreatobiliary duct. Serum TNFα was detected and animals were killed 12 h after drug administration. Changes in content of brain water, MDA and SOD as well as leucocyte adhesion of brain microvessels were measured.RESULTS: In TNFα antibody treated group, serum TNFα level was decreased. Content of brain water, MDA and SOD as well as leucocyte adhesion were decreased significantly in comparison with those of acute necrotizing pancreatitis group (P<0.05).CONCLUSION: TNFα antibody can alleviate the brain damage of rats with acute hemorrhage necrotizing pancreatitis.
文摘目的探讨重症急性胰腺炎(SAP)的治疗原则和方法。方法分析总结我院1992年7月以来98例 SAP 病人的临床表现、手术指征、手术方式、并发症、治疗效果和再次手术等。结果全组98例 SAP 病人(Ⅰ级38例,Ⅱ级60例),治愈83例(84.7%),死亡15例(15.3%),无并发症51例(52.1%)。其中非手术治疗41例(Ⅱ级11例),治愈37例(90.2%);早期手术治疗15例(Ⅱ级15例),治愈10例(66.7%);中转手术22例(Ⅱ级4例),治愈17例(77.3%);择期手术20例(Ⅱ级4例),治愈19例(95%)。结论治疗 SAP 应在坚持"个体化治疗方案"的原则下,充分重视外科治疗手段在治疗 SAP 中的作用。
文摘目的:评价入院时Ranson、急性生理学和长期健康评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、Balthazar CT以及胰腺炎结局预测(pancreatitis outcome prediction,POP)评分系统对重症急性胰腺炎(severe acute pancreatitis,SAP)患者的预后评估价值。方法:回顾性研究了2004年1月～2007年8月在四川大学华西医院住院的253例SAP患者,计算患者入院时Ranson、APACHEⅡ、Balthazar CT和POP的评分分值。观察死亡、胰腺局部并发症、中转手术和多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)发生等4项结局指标。将所有患者的4项评分绘制受试者工作特征(receiver operating characteristic,ROC)曲线,通过计算曲线下面积(area under curve,AUC)来比较各评分系统在判断SAP病情严重度和预后上的敏感性、特异性、Youden指数和阳性似然比(likelihood ratio of positivetest,LRPT)。结果:ROC曲线分析显示Ranson评分可用于预测死亡、中转手术及MODS发生(P=0.00),其诊断阈值均为5。APACHEⅡ评分可以预测胰腺局部并发症以外其他结局指标的发生(P=0.00),APACHEⅡ评分对死亡、中转手术、MODS发生的诊断阈值依次为14、10、12。BalthazarCT评分可预测各项结局指标的发生,诊断阈值均为6。POP评分可预测胰腺局部并发症以外的各项结局指标,其对死亡的预测价值尤为突出,当POP评分≥14时,其预测死亡的敏感性为0.90,特异性为0.92。POP评分对死亡、中转手术、MODS发生的诊断阈值依次为14、8、10。结论:4项评分系统预测能力各有侧重。Ranson、APACHEⅡ和POP评分可以用于疾病的严重程度及全身并发症的预测,对局部并发症的预测效果不佳。POP评分对病死率的预测效果较好;Balthazar CT评分能预测胰腺局部并发症和中转手术的发生及其他结局指标的发生,但敏感性和特异性不高。
