重症急性胰腺炎大鼠的脑损伤及保护对策

Effect of Blood-brain Barrier in the Progress Brain Damage on Rat Severe Acute Pancreatitis and Protection of Somatostatin Combined with Growth Hormone

目的:观察重症急性胰腺炎(SAP)大鼠的脑损伤以及血脑屏障在SAP大鼠脑损伤中的作用。方法:经胰胆管逆行注射3 .5 %牛磺胆酸钠(2 .5mL·kg-1)建立大鼠SAP模型,观察经生长激素和生长抑素不同处理各组动物的血清炎性介质、内毒素和磷脂酶A2的变化,分析各组脑水肿、血脑屏障和脑细胞凋亡与胰腺病理评分的相关性。结果:SAP组动物血清炎性介质、内毒素、磷脂酶A2 表达水平、胰腺病理评分和脑损伤程度较假手术组呈显著性升高(P <0 .0 1)。生长抑素和生长激素联合治疗SAP组动物血清各项指标、胰腺病理评分和脑损伤程度与SAP组相比有显著性减轻。应用多元回归分析显示脑水肿、血脑屏障和脑细胞凋亡与胰腺病理评分有相关性;发现血脑屏障是脑损伤指标中最重要的指标。结论:SAP时脑损伤主要影响血脑屏障,继而引起脑水肿和脑细胞的凋亡。胰腺病理评分与脑损伤程度呈正相关。生长激素和生长抑素联合治疗能显著降低SAP大鼠胰腺病理评分和脑损伤程度。

Aim:To observe the brain damage in severe acute pancreatitis(SAP), and to explore the prevention brain from impairing treated by somatostatin combined with growth hormone in SAP rats.Methods: Retrograde pancreatic injection of 3.5% sodium taurocholate 2.5 mL·kg -1 in rats was used to establish SAP models. The SAP rats were divided into different groups by different disposal. Sham-operation group was also established. Serum cytokines,endotoxin and PLA_2 were measured in each group. Water content in brain tissue,blood-brain barrier permeability and apoptosis of brain cell were also examined . The Schmidt criterion was used for pancreatic pathological evaluation,and study the relationship between pancreatic pathological evaluation and brain damage. Results: Levels of serum cytokines,endotoxin and PLA_2 in SAP group were dramatically higher than SAP treated by somatostatin combined with growth hormone group( P <0.01);at the same pancreatic pathological evaluation and brain damage were also significantly higher ( P <0.01). Brain damage has a positive correlation with pancreatic pathological evaluation. Canonical correlation analyzs demonstrating pancreatic edema,WBC number and aciner cell necrosis mainly determined pancreatic pathological evaluation. Blood-brain barrier wasa main index in the brain damage. Conclusion: Somatostatin combined with growth hormone in SAP rats can decrease pancreatic pathological evaluation, prevent the development of the permeability of blood-brain barrier, and prevent brain damage.