早期大剂量地塞米松治疗重症急性胰腺炎的实验研究

TREATMENT OF SEVERE ACUTE PANCREATITIS WITH LARGE DOSAGE OF DEXAMETHSONE IN THE EARLIER TIME.

目的 观察在不同时间应用不同剂量地塞米松治疗重症急性胰腺炎 (SAP)的疗效。方法 采用经胰胆管注射5 %牛磺胆酸制备 SD大鼠模型 ,分别在模型复制后即刻和 5小时应用地塞米松 0 .5 m g/ 10 0 g和 0 .0 5 mg/ 10 0 mg进行治疗。测定各组血浆淀粉酶及炎症介质白细胞介素 - 6 (IL- 6 )、一氧化氮 (NO)、脂质过氧化物 (L PO)的水平差异及胰腺、肺脏、肾脏的病理学损害程度。结果 应用地塞米松治疗后 ,大鼠血浆淀粉酶、IL- 6、NO、L PO均显著下降 ,生存率提高 ,平均生存时间延长 ,腹水量减少。大剂量较小剂量应用效果好 ,同样剂量早期应用较延迟应用效果好。结论 炎症介质 IL- 6、NO、L PO在 SAP的发生发展中有重要作用 ,早期应用大剂量地塞米松可以降低 SAP大鼠血中的炎症介质水平 。

Objective To observe the therapeutic effects of different dosage of dexamethsone(DXM) in the different time on severe acute pancreatitis(SAP).Methods After SD rats of SAP were established by intra-bilopancreatic duct infusion of 5% sodium taurochlate,animals were divided into four groups:(1)Group A(n=12):SAP group;(2)Group B(n=10):small dosage(0.05mg/100g)of DXM immediate treatment group;(3)Group C(n=15):large dosage(0.5mg/100g)of DXM immediate treatment group;(4)Group D(n=10):small dosage of DXM delayed treatment group;(5)Group E(n=10):large dosage of DXM delayed treatment group;(6)Group F(n=6):control group.Plasma amylase,interleukin-6(IL-6),nitrogen monoxide(NO),lipid peroxidation(LPO) were determined,and light micrpscopes of pancreas,lung and kidney were done.Result In the treatment groups,piasma amylase, IL-6,NO,LPO were decreased.Light microscopy found less damage of the pancreas,lung and kidney as compared with the SAP group.Survival rate increased,the mean survival time prolonged and ascite volume decreased.The effect in the group of large dosage is better than that in the small dosage.And the effect in the group of immediate treatment is better than that in the delayed treatment.Conclusion IL-6,NO and LPO play an important role in the development of SAP.Large dosage of DXM immediate treatment can inhibit over-relased inflammatory mediators in SAP and has a satisfactory effect.