重组葡激酶对重症急性胰腺炎大鼠胰腺组织缺血的影响

Effect of the recombinant staphylokinase on pancreatic ischemia in severe acute pancreatitis of rats

目的观察大鼠重症急性胰腺炎（SAP）时血中内皮素-1（ET-1）、血管性假血友病因子（vWF）、6-酮-前列腺素-F1α（6-keto-PGF1α）、血栓素B2（TXB2）、血小板最大聚集率（PAGm）水平及胰腺组织血流量的变化，评价重组葡激酶（r—Sak）对其的干预作用。方法81只SD大鼠被随机分为假手术组、SAP模型组和r—Sak治疗组，每组27只。采用质量分数为5％的牛磺胆酸钠胰胆管逆行注射方法建立SAP模型。于制模后6、12和18h检测下列指标：用组织血流仪检测胰腺组织的血流量；用放射免疫法检测血中ET-1、TXB2和6-keto-PGF1α含量；用双抗体夹心酶联免疫吸附法（ELISA）测定血中vWF含量；用全自动血小板聚集仪检测胶原和花生四烯酸诱导的PAGm。结果术后6、12和18h SAP模型组大鼠胰腺组织血流量呈逐渐下降趋势，各时间点胰腺组织血流量均较假手术组显著下降（P均〈0．05），且术后各时间点PAGm及血中ET-1、vWF、TXB2含量均较假手术组显著升高，6-keto-PGF1α显著降低（P均〈0.05）；与SAP模型组比较，r—Sak治疗组术后各时间点PAGm、ET-1、vWF、TXB2含量均显著降低，6-keto-PGF1α则显著升高（P均〈0.05）。结论r—Sak可明显改善SAP大鼠胰腺的微循环，增加胰腺组织的血流量，对SAP大鼠具有积极的治疗作用。

Objective To investigate the changes in plasma endothelin - 1 （ET - 1）, yon Willebrand factor （vWF）, serum 6 - keto - prostaglandin1α（PGF1α） , thromboxane B2 （TXB2）, platelet aggregation rate maximum （PAGm） and pancreatic blood flow after reproduction of severe acute pancreatitis （SAP） in rat, and the effect of recombinant staphylokinase （r -Sak） on SAP. Methods Eighty -one SD rats were divided randomly into the sham -operated group （n= 27）, the SAP model group （n= 27）, and the r -Sak treatment group （n= 27）. SAP was produced by administration of 5% sodium taurocholate into the pancreatic duct. The abdomen of rats was opened at 6, 12 and 18 hours after reproduction of SAP for determining the pancreatic blood flow. Blood was obtained at 6, 12 and 18 hours after reproduction of SAP for determining the concentration of plasma vWF with enzyme -labeled immunosorbent assay （ELISA）. The concentration of plasma ET - 1 and serum 6 - keto - PGF1α, and TXB2 were detected by radioimmunossay. The PAGm induced by collagen and eicosanoids was assessed. Results Pancreatic blood flow in the SAP group appeared to have a decreasing trend at 6,12 and 18 hours after operation and were significantly decreased at all time points after reproduction of the model, compared with those of the sham -operated group （all P〈0.05）. The PAGm, content of plasma ET-1, vWF, and TXB2 were significantly increased at all time points after reproduction of the model, while 6 - keto - PGF1α was significantly decreased, compared with those of the sham -operated group （all P〈0.05）. Compared with SAP model group, PAGm, the content of plasma ET- 1, vWF, and serum TXB2 in the r -Sak group were decreased at all time points, however, the content of serum 6 -keto- PGF1α was increased （all P〈0.05）. Conclusion The r -Sak can improve pancreatic microcirculation and enhance pancreatic blood flow in rats with SAP, and may be beneficial in the treatment of SAP.