生长抑素和生长激素对重症急性胰腺炎肝损害的保护作用

EFFECTS OF SOMATOSTATIN WITH GROWTH HORMONE ON LIVER INJURY IN DOG SAP

目的 :实验性研究重症急性胰腺炎 ( SAP)早期肝脏损害与血清肿瘤坏死因子 ( TNFα)水平变化的关系 ;探讨生长抑素 ( SS)和生长激素 ( GH)合理组合治疗的作用。方法 :经胰管开口逆行注入 5 %的牛磺胆酸钠 2m L/kg诱导犬 SAP模型。取 2 0只杂种犬随机分成 4组 ,每组 5只 ;分为假手术组 ;SAP模型组 ;SS治疗组 ;SS和 GH不同时段治疗组。所有实验动物模型制备后第 6、1 2、2 4、48h采血测定血清淀粉酶、TNFα、白蛋白、ALT和 AST。观察胰、肝组织的病理变化和细胞超微结构改变并与假手术组比较。结果 :SAP早期血清 TNFα、ALT和 AST升高与肝脏损害程度有关 ;SS和 GH不同时段应用可以明显降低血清淀粉酶、TNFα和减轻胰、肝组织的炎性反应 ,病理损害。结论 :SS和 GH通过抑制胰酶、降低 SAP炎性介质的过度释放 ,抑制胰、肝组织的炎性反应 ,对

Objective: To study the change of the serum tumor necrosis factor α (TNFα) and their relations to liver damage in early severe acute pancreatitis (SAP) of dog model; to investigate the effect of somatostatin (SS) and growth hormone (GH) on dog SAP. Methods: 5% sodium taurocholate 2 mg/kg was injected into the main pancreatic duct to induce canine SAP model. Twenty dogs were randomly divided into four groups; Control group (n=5)、SAP model group (n=5)、 SS treatment group (n=5), SS and GH treatment group (n=5) in different phase. Serum levels of amylase (AMY), TNFα, albumin, ALT and AST were measured in 6 h, 12 h, 24 h, 48 h. In addition, histological changes of the pancreas and liver were examined by light and electron microscope in 48 hours after inducing SAP models. Those results are compared with control group. Results: The elevations of early serum TNFα, ALT and AST are correlated with the degree of liver damage. The application of SS and GH in different phase could decrease the serum AMY, TNFα and ease the liver's inflammation reaction and histopathologic damage. Conclusion: Appropriate application of SS and GH can inhibit AMY and SAP inflammatory mediators and pancreas liver inflammation, which prevents the development of SAP and protect the pancreas and liver from damage.