生长抑素对膀胱引流式犬胰腺移植Oddi括约肌及外分泌功能的影响

Effects of somatostatin on Oddi sphincter motility and exocrine function after pancreatic transplantation with bladder drainage in dogs

目的 研究人工合成的生长抑素类似物思他宁对膀胱引流式犬胰腺移植后移植物Od di括约肌(SO)和外分泌功能的影响。方法 正常犬和膀胱引流式胰腺移植后犬应用思他宁前后进 行SO测压,检测移植后犬应用思他宁前后尿中胰蛋白酶原激活肽(TAP)和淀粉酶水平。结果 正 常犬SO有规律收缩,基础压为(18.5±2.8)mmHg,收缩频率为(9.7±1.5)次/min,收缩幅度为 (47.1±5.5)mmHg,动力指数为(235.6±56.1)。应用思他宁后SO基础压、收缩频率、收缩幅度和 动力指数分别显著降低为(11.5±4.3)mmHg,(3.8±0.8)次/min,(22.7±5.3)mmHg和(76.9± 16.4),与用药前相比,P均<0.01。移植物SO基础压和收缩频率分别升高为(27.8±2.8)mmHg和 (13.1±1.9)次/min,收缩幅度缩小为(8.3±1.8)mmHg,动力指数无明显变化。移植犬应用思他宁 后,SO基础压和动力指数分别升高为(35.2±4.2)mmHg和(418.7±81.5),与用药前相比,P均< 0.01。收缩频率和幅度无明显变化(P>0.05)。用思他宁后尿淀粉酶和TAP水平分别显著降低为 (5000±350)IU/L和(15.6±3.7)nom/L,与用药前相比,P<0.01。结论 生理情况下,思他宁可 抑制犬SO运动,胰腺移植后,思他宁对移植物SO起直接激动作用,思他宁还可以降低膀胱引流式犬

Objective To study the effects of somatostatin on Oddi sphincter (SO) motility and graft exocrine function after pancreatic transplantation with bladder drainage in dogs. Methods SO manometry was performed in normal dogs and those receiving pancreatic transplantation with bladder drainage before and after administration of somatostatin. Meanwhile, the urine levels of TAP and amylase before and after administration of somatostatin were determined postoperatively. Results In the control dogs, SO basal pressure, the frequency, amplitude and motility index were significantly decreased from 18.5±2.8 mmHg, (9.7±1.5) per min, 47.1±5.5 mmHg and 235.6±56.1 before to 11.5±4.3 mmHg, (3.8±0.8) per min, 22.7±5.3 mmHg and 76.9±16.4 in 1-2 min after administration of somatostatin. In the dogs receiving pancreatic transplantation, the basal pressure and the frequency were markedly increased to 27.8±2.8 mmHg and (13.1±1.9) per min as compared with the controls (P<0.01). After the administration of somatostatin, the basal pressure and motility index were remarkably increased to 35.2 mmHg and 418.7±81.5 in the dogs receiving the pancreatic transplantation (P<0.01). However, there were no significant changes in the frequency and amplitude. Urine levels of amylase and active trypsin were significantly decreased on day 5 after the administration of somatostatin (P<0.01). Conclusions Somatostatin can inhibit SO motility in the control dogs but simulate it after transplantation. Meanwhile, it can decrease urine levels of amylase and trypsinogen activation peptide. This will help to prevent graft pancreatitis.