腹膜透析对急性重症胰腺炎大鼠胰腺微循环的影响

Impact of peritoneal dialysis on the status in microcirculation of acute severe pancreatitis model

目的:探讨腹膜透析(PD)对急性重症胰腺炎(ASP)大鼠胰腺微循环的影响。方法:SD大鼠72只随机分为对照组(24只)、ASP组(24只)和ASP加PD组(24只);观察各组血清血栓素A2/前列腺素(TXA2/6-K-PGF1a)和内皮素(ET-1)水平,以及胰腺血流波幅和胰腺病理变化。结果:ASP组和PD组血清ET-1水平较对照组明显升高;在同时段病例中,ASP组与加PD组比较,后者的水平明显降低;ASP组和加PD组血清TXA2/6-K-PGF1a水平较对照组明显升高;同时段ASP组与加PD组比较,后者的水平明显降低。ASP组胰腺血流波幅明显降低,加PD治疗后波幅有显著提高。加PD组大鼠的胰腺病理损害较ASP组明显减轻。结论:微循环障碍是ASP的重要病理生理基础,早期行PD治疗能有效地改善ASP所致之血微循环障碍,对胰腺有保护作用。

Objective To study the impact of peritoneal dialysis （PD） on the status of microcirculation of acute severe pancreatitis（ASP） model. Methods Using a rat model of acute severe pancreatitis, 72 SD rats were randomly divided into 3 groups： control group, ASP group and ASP ＋ PD group. The blood concentration of TXA2, 6-K-PGF1a and ET-1 were measured, and the pancreatic blood flow （PBF） was scaled by Doppler uhrasonography. The pathological alterations of the pancreas were also observed in all groups. Results The TXA2, 6-K-PGF1a and ET-1 levels in the ASP and ASP＋PD groups were significantly higher than that of the control group. Furthermore, compared with the ASP group, the levels of these cytokines were significantly reduced in the ASP＋PD group. PBF was reduced in the ASP group, but significantly elevated in the ASP＋PD group. The scoring of pancreatic damages in the ASP＋PD group was lower than that of the ASP group. Conclusions Microcirculation derangement is the basic patho-physiological change leading to the pancreatic lesion of ASP, the early application of PD could ameliorate the microcirculation and prevent further damage.