実験的急性膵炎に対するデキサメサゾンの効果に関する研究
1968 年 65 巻 8 号 p. 811-827
詳細
1968 年 65 巻 8 号 p. 811-827
Experimental acute pancreatitis was produced in 63 mongrel dogs, by introducing staphylococcal toxin into the pancreatic duct. The effects of dexamethasone on survival rate, leucocyte counts, serum amylase, serum lipase, serum trypsin inhibitor, volume and pancreatic enzymes of the intraperitoneal exsudate and pathological findings of the pancreas, liver, kidney and adrenal gland. were observed.
The results are summerized as follows:
1) In the 15 control dogs, there was a survival rate of 6.6% and in the fatal cases among them, there was a survival time less than 24 hours. In the 23 dogs treated with dexamethasone or dexamethasone and mycilline, survival rates were 30.7% or 50%, respectively, while in fatal cases, an improvement in survival time was found. Statisticaly significant differences were found between dexamethasone-treated dogs and the control group, as to survival rate and time. In 7 dogs treated with dextran, the survival rate was 14.3%, but the improvement in survival time was significant when compared with the con trol group.
2) As to leucocyte count, serum amylase, serum lipase, serum trypsin inhibitor, and volme and pancreatic enzymes of the intraperitoneal exsudate, there were No significant differences between dexamethasone-treated dogs and the control group.
3) In fatal cases, the pathological findings of the pancreas in treated dogs were identical with those observed in control dogs. In the sacrificed cases, the dextran and dexamethasonetreated dogs, in contrast to the dextran-treated dogs showed, after 12 hours slight pathological changes of the pancreas, liver and kidney, that is, pancreatic hemorrhage and necrosis, congestion of the sinusoid and edema of the Disse's spaces in the liver, and degeneration of the distal uriniferous tubulus in the kidney.
4) Adrenocortical hormones are considered beneficial in acute pancreatitis, probably due to, its anti-shock effect. In the treatment of acute pancreatitis, not only large dosis, of adrenocortical hormones, but an infusion adequate to maintain an effective circulating plasma volume, should be administered promptly, to reverse the hemodynamic deficits of this type of shock.
