急性坏死性胰腺炎大鼠的炎性介质变化和生长抑素的作用

Changes of inflammtory mediator in aucte necrotiaing pancreatitis and effect of somatostatin analogne stilamin in rats

探讨急性坏死性胰腺炎（ＡＮＰ）大鼠的炎性介质变化和生长抑素（ｓｔｉｌａｍｉｎ）的治疗作用。方法将ＳＤ大鼠随机分为ＡＮＰ组，ＡＮＰ＋生理盐水治疗组（ＡＮＰ＋ＮＳ），ＡＮＰ＋Ｓｔｉｌａｍｉｎ治疗组（ＡＮＰ＋Ｓ）和正常对照组（ＮＣ）。经胰胆管逆行注射３．５％牛磺胆酸建立大鼠ＡＮＰ模型。测定血的ＩＬ－１β，ＩＬ－６，ＩＬ－１２，ＴＮＦα和内毒素，淀粉酶，磷脂酶Ａ２，并对内脏标本行病理检查及电镜分析。结果在ＡＮＰ组和ＡＮＰ＋ＮＳ组的内毒素为２５０±１３ｐｇ／ｍｌ，２３０±１６ｐｇ／ｍｌ；淀粉酶３００００±８００Ｕ／Ｌ，２８０００±５２Ｕ／Ｌ；磷脂酶Ａ２２３０±３４Ｕ／Ｌ，２２４±２８Ｕ／Ｌ及细胞因子的水平与ＡＮＰ＋Ｓ和ＮＣ组比较，均有统计学意义。ＡＮ＋ＮＳ和ＡＮＰ组可引起心、肝、肾、肺的严重损伤，而ＡＮＰ＋Ｓ组的多器官损伤则明显减轻。结论ＡＮＰ引起多器官损伤与炎性介质过度表达有关，生长抑素对ＡＮＰ的治疗有效。

Objectives To investigate the changes of inflammatory mediator in ANP and to explore the effectiveness of stilamin treatment on ANP.Methods SD rats were divided into experimental groups(ANP =12,ANP+NS=10,ANP+Stilamin=12)and control group(NC=10).Rat ANP models were made by retrograde injection of 3.5%sodium taurocholate2.5ml/kg into the pancreatic duct,and treated by intravenous injection of stilamin84μg·kg -1 ·d -1 or same amount of normal saline respectively. Serum IL 1β,IL 6,IL 12,TNF α,PLA2,amylase and endotoxin were examined.Finally,the morphology and pathology of the pancreas,liver,lung,heart and kidney,as well as the electronmicroscopical investigation of liver and lung cells were observed.Results The mean IL 1β,IL 6,IL 12, TNF α,in the ANP and ANP+NS group were higher than those in the ANP+stilamin group and Control group( P <0.01).The endotoxin,amlyase,PLA2level in the ANP+stilamin group was lower than those in the ANP and ANP+NS groups( P <0.001).ANP significantly increased white blood cell chemotax and infiltration,as well as hemorrhagic focus in liver,kidney and lung,but the pathological examinations of the liver,pancreas,lung and kidney demonstrated much less destruction in the stilamin group.Conclusions Inflammatory cytokins play an essential role to induce pathophysiological