大鼠重症急性胰腺炎中胰酶自身消化作用及善得定治疗效果

The role of enzymatic autodigestion in rats with severe acute pancreatitis and its treatment of sandostatin

目的:观察大鼠重症急性胰腺炎中胰酶的自身消化作用及善得定的治疗效果.方法:以3%牛磺胆酸钠经胆胰管逆行注射制成大鼠重症急性出血坏死性胰腺炎(SAP)并用善得定进行治疗,并观察血清、十二指肠液、胰腺组织磷脂酶A_2(PLA_2)活性变化及胰腺组织学改变.结果:SAP6小时出现严重的胰腺出血坏死,血清PLA_2活性显著升高(P<0.01),十二指肠液、胰腺组织PLA_2活性显著降低(P<0.01),12小时后均进行性降低,胰腺组织学改变则进行性加重;治疗组12小时内的三种PLA_2活性比对照组显著改善(P<0.01).结论:胰酶自身消化是SAP早期胰腺病变的主要原因,善得定对SAP有一定的治疗作用,但只宜早期应用,且持续时间不宜太长.

The rat model of severe acute pancreatitis (SAP) was developed by retrograded injection of 3% sodium taurocholate into biliopancreatic duct in rats and then treated with sandostatin. 6 h after injection, the increase of PLA2 activity in serum and the de-cerase of PLA2 activity in duodenal juice and pancreas were found in SAP rats with hemorrhagic necrosis. 12h later, all the indices above decreased proceedingly with deteriorating histologic changes in pancreas. Compared with the control group,the relative indices were significantly decreased and the histologic changes in pancreas were ameliorated 12 h after treatment in the treated group. These results suggested that the enzymatic au-todigestion played a role in the early stage of pancreatitis and the short treatmtnt with sandostatin had some effects on SAP in the early stage.