내시경적 역행성 담췌관 조영술후 발생하는 고아밀라제혈증의 병인에 산소유리기의 역할 = Role of Oxygen-Derived Free Radical in the ERCF-Induced Hyperamylasemia

다국어 초록 (Multilingual Abstract)

There is growing evidence that oxygen-derived free radicals(OFR's) play a role in the pathogenesis of pancreatic diseases, especially of acute paetcreatitis. Many types of experimental ex vivo and in vitro pancreatitis can be inhibited by superoxide dismutase and catalse. Allopurinol also ameliorates the injury response. While these experiments strongly suggest the involvement of OFR's in some forms of experimental acute pancreatitis, their clinical significance is still unknown. Clinical trials with free radical scavengers or allopurinol are clearly needed to answer the question of free radical initiation of acute or chronic pancreatitis. The aim of this study was to know the role of OFR's on the ERCP-induced hyperamylasemia. Total forty-two patients who underwent ERCP for diagnostic purposes were included and randomly divided into two group6, non-pretreatment group(NP group 19 patients) and pretreatment group(P group, 23 patients pretreated with vitamin E 1000 I.U. and allpurinol 300 mg for 5 days before ERCP orally). 15 ml of venous bloods were drawn in EDTA treated tubes. Serial changes of serum amylase levels(U/ml), washed RBC malonyDdialdehyde levels(MDA, nmol/ml RBC), buffy coats myeloperoxidase activites(MPO, U/ml buffy coats), and plasma superoxide dismutase levels(SOD, U/ml) were measured before, 2 and 24 hours after ERCP, respectively. Serum amylase levels in P group were decreased than NP group, but without statistical significance. The mean RBC MDA levels of P group measuted 2 hr after FRCP were 3.43±1.13, which were significantly decreased than those of NP group(5.27±1.53)(p$lt;0.05). The plasma SOD levels of P group were 17.71
1.8, 20.41±1.3, 19.4±2.2 at before, 2 and 24 hr after FRCP, respectively, which were all significantly decreased than those of NP group(p$lt;0.05). The huffy coats MPO activities were not changed at all in spite of pretreatment. In conclusion, OFR's might be in volved in the pathogenesis of ERCP-induced hyperamylasemia, but do not play a major role. A protective effect of allopurinol and vitamin E could be expected.