奥曲肽治疗大鼠急性坏死性胰腺炎并急性肺损伤的实验研究

An experimental study on therapeutic effect of Octreotide on lung injury in rat model of acute necrotizing pancreatitis

目的探讨奥曲肽对急性坏死性胰腺炎并急性肺损伤治疗影响。方法选日龄21 dSD大鼠为实验对象,并随机分为实验组(E组,n=6)、治疗组(T组,n=6)和对照组(C组,n=6)。采用十二指肠结扎胰管注射5%牛磺胆酸钠法建立急性坏死性胰腺炎并发急性肺损伤动物模型。E组在胰管中注入5%牛磺胆酸钠,C组注入生理盐水,T组在注入5%牛磺胆酸钠前1 h静脉注入生长抑素类药物奥曲肽。0、2、4、6 h分别取动脉血作血气分析,取静脉血作淀粉酶测定,6 h后取右肺进行支气管肺泡灌洗,灌洗液做中性粒细胞计数、分类和白蛋白含量分析。然后取左肺做肺湿重和肺干重称重,计算两者比值。结果注射5%牛磺胆酸钠2 h后,E组动物PaO2升高,4 h开始下降,6 h下降更明显,C组各时段变化无显著性,而T组变化规律与E组相似,但变化幅度明显减小。血淀粉酶都表现出相似的特征。支气管肺泡灌洗液白蛋白、中性粒细胞计数和分类,E组与C、T比较有显著性差异,C组与T组比较无显著性差异。结论生长抑素类药物奥曲肽能明显降低急性坏死性胰腺炎并肺损伤大鼠的肺泡炎性渗出,从而减轻肺损伤。

Objective To explore therapeutic effect of Octreotide on rat model of acute necrotizing pancreatitis （ANP） combined with acute lung injury （ALI）. Methods Eighteen 21-day-old Sprague Dawley rats were randomly divided into three groups：control group（group C, n = 6）, treatment group（group T, n = 6）,experiment group（group E, n = 6）. ANP model was established by injecting 5 % sodium taurocholate solution into bilo-pancreatic duct. After being anesthetized successfully, SD rats of group E were induced by injecting 5% sodium taurocholate solution into bilo-pancreatic duct, while those of group C were injected with 0.9 % saline solution, but in group T, Octriotide had been used 1 hour before injecting 5 % Taurocholic acid. Additionally for the group T, Octriotide was continuously given by a mini-pump via a central intravenous line. Arterial blood gas and serum amylase level were determined at the time point of 0, 2, 4, 6 h. Bronchoalveolar lavage fluid （BALF） was collected for analysis of neutrophil, polymorphnuclear leukocyte （PMN）, macrophage （MA） and albumin level. Meanwhile, wet lung/dry lung weight ratio was counted. Results Arterial blood gas analysis indicated that PaOz of Group E increased at 2 h but decreased at 4 h and more significantly at 6 h; that Group C had no significant change; and that Group T had no significant difference with Group C but both Group C and Group T showed higher PaO2 level as compared with Group E, suggesting the therapeutic effect of Octreotide. For all the three groups, serum amylase showed similar change with that of PaO2 value. BALF parameters （PMN, MA and albumin level） were significantly higher in group E than those in group T and C. Conclusion Octreotide can significantly relieve alveolar inflammatory exudation in rat model of acute necrotizing pancreatitis associated with acute lung injury.