牛磺胆酸钠诱导的急性坏死性胰腺炎大鼠脏器功能障碍观察

Observation on organ’s dysfunction of rats in sodium taurocholate-induced acute necrosis pancreatitis

目的探讨急性坏死性胰腺炎大鼠脏器功能障碍及病程演进规律。方法大鼠分为两组,急性坏死性胰腺炎(acute necrosis pancreatitis,ANP)组64只,对照组48只。采用经胰管逆行注射5%牛磺胆酸钠诱导ANP,对照组予胰管内注射生理盐水。分别于模型诱导后3、6、9、12、18、24h(每一时间点各8只大鼠)处死,测定大鼠呼吸、体温、心率、血白细胞、肝肾功能及血气分析,另有16只ANP大鼠观察其24h生存率。结果ANP组24h生存率为75%。ANP组在模型制备后3h体温、心率、血白细胞明显高于对照组(P<0.05),6h血清乳酸脱氢酶水平显著升高(2613vs1822IU/L,P<0.05),9h血清肌酐水平显著升高(27.5vs18.7μmol/L,P<0.05),12h动脉血PaO2显著降低(7.8vs12.5kPa,P<0.05),18h之后各脏器处于衰竭期。对照组无脏器功能障碍表现。ANP组各时间点胰腺病理学评分显著高于对照组。结论在5%牛磺胆酸钠诱导的ANP病程中,3h后出现全身炎症反应综合征,6h出现肝功能障碍,9h后进入多脏器功能障碍期,18h后进入多脏器衰竭期。

Objective To explore organ’s dysfunction in sodium taurocholate-induced acute necrosis pancreatitis （ANP） in a rat model. Methods ANP （n=64） was induced in the rats by retrograde injection of 5% sodium taurocholate solution into the pancreatic duct of male Sprague-Dawley rats. In the controls （n=48）, the normal saline was injected into the pancreatic duct. The rats in each group were sacrificed at 3, 6, 9, 12, 18 and 24 h after the model was induced （each time point had 8 rats）. Respiratory rate, body temperature, heart rate, blood WBC, liver and kidney function and blood gas analysis of rats were determined. Survival rate at 24 h was observed in another 16 ANP rats. Results Twenty-four h survival rate in ANP group was 75%. At 3 h after the model of performance in the ANP group, the body temperature, heart rate, blood leukocytes showed significant elevation compared with the control group （P〈0.05）; 6 h serum LDH levels significantly higher （2 613 vs 1 822 IU/L, P〈0.05）, 9 h serum creatinine levels significantly higher （27.5 vs 18.7 μmol/L, P〈0.05）. Blood PaO2 （7.8 vs 12.5 kPa, P〈0.05） significantly reduced at 12 h, and multiple organ failure occurred at 18 h. The control group hadn’t organ dysfunction performance. Pancreatic pathology score of ANP group at different time points was significantly higher than that of control group. Conclusion In the ANP course induced by 5% sodium taurocholate, systemic inflammatory response syndrome occurs at 3 h after the model of performance, liver dysfunction occurs at 6 h, multiple organ dysfunction at 9 h, and multiple organ failure occurs after 18 h.