雷公藤多甙联合生长抑素治疗对大鼠急性坏死性胰腺炎肠道细菌移位的影响

The effect of treatment with extract of tripterygium wilfordii hook F combined with somatostatin on bacterial translocation caused by acute necrotizing pancreatitis in rat

目的探讨雷公藤多甙联合生长抑素治疗对大鼠急性坏死性胰腺炎(ANP)肠道细菌移位的影响。方法逆行胰胆管穿刺注射3.5%牛磺胆酸钠(0.2ml/100g)诱导ANP大鼠模型。分为5组:假手术组(SO)、坏死组(ANP)、生长抑素治疗组(ANP+S)、雷公藤多甙治疗组(ANP+T)、雷公藤多甙+生长抑素治疗组(ANP+T+S)。术后禁食12h,不禁水。各组均随机标记6只观察术后生存时间。术后24h,观察血清淀粉酶、血清脂肪酶活性,血浆内毒素水平,脏器细菌培养结果,胰腺和回肠黏膜病理学变化及大鼠存活率。结果雷公藤多甙与生长抑素联合治疗ANP大鼠,可以显著降低血清淀粉酶、血清脂肪酶活性;减轻胰腺组织和肠黏膜炎症细胞浸润、水肿;降低血浆内毒素水平和脏器细菌培养阳性率;提高ANP大鼠存活率。结论ANP大鼠存在肠道细菌移位;雷公藤多甙联合生长抑素的治疗可减轻ANP大鼠胰腺和肠道损伤,加强肠道的生物学屏障,降低肠源性细菌及内毒素移位发生率,阻止ANP的发展。

Objective To investigate the effect of extract of tripterygium wilfordii hook F （T） combined with somatostafin （S） treatment on bacterial translocafion from gut caused by acute necrotizing pancreatitis （ANP） in rat. Methods ANP rat were indued by retrograde infusion of 3.5 % sodium taurocholate into biliary-pancreatic duct, the rats were divided into 5 groups： sham operation （SO） group, ANP group, ANP＋S group,ANP＋ T group and ANP＋T＋ S group. Serum amylase,lipase activities,and plasma endotoxin level were measured at 24 hours after operation and treatment. The pathological changes of pancreatic tissue and ileal mucosa were studied. Bacterial cultures from serum, ascites, liver, and mesenteric lymph nodes （MLNs） were also examinod. Survival rate during 3 days after treatment was observed. Results T combined with S treatment significantly decreased amylase, lipase activities, and plasma endotoxin level. Edema and inflammation in pancreas and ileal mucosa were also alleviated. Positive bacterial culture.s from blood, ascites, liver, pancreas and mesenteric lymph nodes （MLNs） were reduced obviously. Survival rate of rats in ANP ＋ T ＋ S group was higher than that of rats in ANP group. Conclusion Bacterial translocation is present in experimental ANP in rats. Treatment of T combined with S shows their beneficial effects on protecting the pancreas from bacterial infection which is caned by bacterial translocafion and improving the outcome of rats with ANP.