Objective:To investigate low molecular weight heparin (LMWH) therapy for pancreatic encephalopathy in severe acute pancreatitis (SAP).
Methods: SD rats were randomly divided into 3 groups: (1) Sham operation (S) group，(2) SAP group and (3) LMWH treatment (LT) group：LMWH was administrated at 4 hours after construction of SAP model. The levels of serum amylase, myelin basic protein (MBP), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), brain water contents and pathological changes of pancreas and brain were measured at 24 h after models were set up in SAP and in S group，and 24 h after LMWH was administrated in LT group.
Results:(1) The levels of serum amylase, TNF-α, IL-6 in SAP group were significantly higher than those in S group and LT group (all P＜0.001); the levels of serum MBP in SAP group were significantly higher than those in S group and LT group(P＜0.01,<0.05 respectively), and the level of serum amylase and IL-6 in LT group were significantly  higher than those in S group (P＜0.05,<0.001 respectively); but the levels of TNF-α and MBP showed no significant difference between LT group and S group (all P＞0.05). (2) The brain water content in SAP group was significantly higher than that in S group and LT group (P＜0.01, <0.05 respectively). (3) Patch necrosis of acinar cells and massive hemorrhagic changes of pancreas could be observed in SAP group, but the necrosis of acinar cells and hemorrhagic changes in LT group were markedly less severe than those in SAP group. (4) In encephalon tissue of SAP group, demyelination, neuronal apoptosis, and mitochondrial vacuolation in neuronal cells were observed; but in LT group, there were significantly less demyelination and mitochondrial edema of neuronal cells than those in SAP group, and neuronal apoptosis was not found in LT group.
Conclusions: LMWH treatment can significantly reduce the release of pancreatic enzymes, reduce neuronal apoptosis and inhibit the production of inflammatory mediators,and thus reduce the occurrence of pancreatic encephalopathy in SAP.