大黄素与善得定对重症胰腺炎胰缺血的影响及机制

Effects and Mechanism of Emodin and Sandostatin on Pancreatic Ischemia in Acute Haemorrhagic Necrotizing Pancreatitis

目的：研究重症胰腺炎（ａｃｕｔｅｈａｅｍｏｒｒｈａｇｉｃ－ｎｅｃｒｏｔｉｚｉｎｇｐａｎｃｒｅａｔｉｔｉｓ，ＡＨＮＰ）胰组织血流的变化和二十碳烯酸类产物的异常代谢，探讨大黄素和善得定对这些指标的影响。方法：以牛磺胆酸钠诱发大鼠ＡＨＮＰ模型、计算机化血流仪测定胰组织动态血流变化、放免法测定血前列腺素Ｅ２（ｐｒｏｓｔａｇｌａｎｄｉｎＥ２，ＰＧＥ２）、６－酮－前列腺素Ｆ１α（６－ｋｅｔｏ－ｐｒｏｓｔａｇｌａｎｄｉｎＦ１α，６－ｋｅｔｏ－ＰＧＦ１α）、血栓素Ｂ２（ｔｈｒｏｍｂｏｘａｎｅＢ２，ＴＸＢ２）等。结果：ＡＨＮＰ初期胰组织血流显著降低；与非治疗组相比，大黄素组胰组织血流降低被显著阻遏；善得定组在发病前即因给药而胰组织血流降低，但发病后胰组织血流降低值较之于非治疗组显著减轻。非治疗组ＴＸＢ２显著增高，发病６ｈ达假手术组的４．５倍；６－ｋｅｔｏ－ＰＧＦ１α与ＰＧＥ２则呈下降趋势。大黄素或善得定组上述二十碳烯酸类异常代谢明显被纠正。病理组织学评分及电镜超微结构观察示给药组腺细胞坏死表现等显著轻于非治疗组。药物治疗两组１２ｈ的生存率显著高于非治疗组。结论：大黄素或善得定可显著改善ＡＨＮＰ初期胰缺血。

To investigate pancreatic ischemia and abnormal metabolism of eicosanoids in acute haemorrhagic-necrotizing pancreatits (AHNP) and the effects of emodin or sandostatin on them.Methods: rats with AHNP were triggered with sodium taurocholate; the pancreatic blood flow (PBF) was detected with computerized tissue blood flowmeter, and plasma prostaglandin E2 (PGE2), 6-keto-prostaglandin F1α(6-keto-PGF1α) and thromboxane (TXB2) were determind with radioimmunoassay. Results: There was a significant decrease of PBF in the early stage of AHNP.Compared with that in the untreated group, significant improvement of PBF was demonstrated in emodin as well as in sandostatin group which showed reduced PBF following infusion of sandostatin before triggering AHNP. In untreated group plasma TXB was significantly higher, with an increase of 4.5 times, than that in sham-operated group while 6-keto-PGF1α or PGE2 tended to decrease. The above mentioned abnormal synthesis of eicosanoids was blocked either in emodin or in sandostatin group in which lessened damage of acini cells was shown by pathologic scoring or transmission electron microscope. Both of the two groups shared significantly lower mortalities than the untreated group. Conclusion: Either emodion or sandostatin could partly reverse the decrease of PBF in the early sarge of AHNP, which may be ascribed at least in part to inhibition of abnormal synthesis of eicosanoids and improvement of cytoprotection of acini cells, and combined application of the two drugs might promise positively synergetic action as well.