Experimental Study Of Local Arterial Infusion With Low Molecularweight Heparin In Treatment Of Severe Acute Pancreatitis

Objective:To investigate the therapeutic effect of local arterial infusion (LAI) with low molecular weight heparin (LMWH) on severe acute pancreatitis (SAP) and its effect on the serum levels of TNF-a, IL-6and IL-10.Methods:Twenty-four healthy adult rabbits were randomized into the sham operation group, SAP model group, SAP plus LMWH intravenous injection group (IV group) and SAP plus LMWH LAI group (LAI group). SAP model was established by injection with5%sodium taurocholate under pancreatic capsule, and the rabbits of the two treatment groups were given LMWH (300IU/kg) by intravenous injection or LAI, respectively. The serum levels of TNF-a, IL-6and IL-10in rabbits of each group were detected at0.5,3,6and12h after surgery and the pathological changes of pancreatic tissues were also assessed.Results:After surgery, the serum levels of TNF-a and IL-6of the sham operation group slowly elevated, while those of the remaining groups were markedly increased within0.5to6h that all had statistical differences compared with the sham operation group (P<0.05or P,0.01), and then gradually declined. The serum levels of TNF-a and IL-6of the IV group and LAI group were all significantly lower than those of the SAP group at each observation time point (P<0.05or P<0.01) and, further, the decreasing degrees of the two factors in the LAI group were more pronounced than those in the IV group (P<0.05or P<0.01). The level of IL-10of the sham operation group had no obvious alteration over the observation period after surgery, while it was markedly decreased in the SAP group from6h later that all had statistical differences compared with the sham operation group (all P<0.01). The level of IL-10of the IV and LAI group markedly increased that all had statistical differences compared with the SAP group (P<0.05or P<0.01) and, furthermore, its increasing degree in the LAI group was more pronounced than that in the IV group (P<0.01). Except for the sham operation group, all the pancreatic tissues of the other groups exhibited pathological characteristics of SAP with varying degrees, among which the most serious was in the SAP group, the next was IV group, and the last was LAI group.Conclusion:LMWH can decrease the TNF-a and IL-6levels while increase the IL-10level in rabbits with SAP. And it has therapeutic effect on SAP and the LAI administration is more effective than intravenous injection.