高压氧联合乌司他丁治疗对大鼠急性坏死性胰腺炎的实验研究

Study of combined hyperbaric oxygen and ulinastatin treatment on acute necrotizing pancreatitis in rats

目的探讨高压氧(HBO)与乌司他丁联合治疗大鼠急性坏死性胰腺炎对(ANP)血内毒素,sCD14,血浆灭活内毒素能力(EIC)及其预后的影响。方法将SD大鼠随机分为正常对照组(A组),假手术组(B组),ANP组(C组),ANP+HBO组(D组),ANP+乌司他丁组(E组),ANP+HBO+乌司他丁组(F组)。模型建立5 min后,E组和F组门静脉注射乌司他丁(20 000 U/kg);30 min后,D组和F组给予HBO治疗2 h。3,6,10 h后各组分别测定血清内毒素,sCD14,EIC,肿瘤坏死因子α(TNF-α),观察各组大鼠的生存时间。结果 (1)D,E组内毒素和sCD14水平在建模后3,6 h均明显低于C组(P<0.05),F组内毒素和sCD14水平在建模后3,6,10 h明显低于C,D,E组(P<0.05)。(2)建模3,6,10 h,D,E,F组的EIC水平明显高于C组(P<0.05),F组的EIC水平均明显高于D,E组(P<0.05)。(3)建模3,6,10 h,D,E,F组的TNF-α水平明显低于C组(P<0.05),F组的TNF-α水平明显低于D,E组(P<0.05)。(4)D,E,F组的生存时间明显超过C组(P<0.05),F组的生存时间明显超过D,E组(P<0.05)。结论单独应用高压氧和乌司他丁治疗ANP,均能取得明显疗效,但高压氧和乌司他丁联合治疗的效果优于单一种方法的效果。

Objective To study the combined hyperbaric oxygen（HBO） and ulinastatin treatment on plasma endotoxin,sCD14and plasma endotoxin inactivation capacity（EIC） in acute necrotizing pancreatitis（ANP） in rats,and its effect on prognosis.Methods SD rats were divided into control group（group A）,sham operation group（group B）,ANP group（group C）,ANP＋HBO group（group D）,ANP＋unlinastatin group（group E）,and ANP＋HBO＋unlinastatin group（group F） randomly.Rat ANP model was made by retrograde injection of 3.5% sodium taurocholate（2.5 ml/kg） via the pancreatic duct;5 min after model had been made,group E and group F were injected with unlinastatin（20 000 U/kg） via portal vein;30 mins after model had been made,group D and group F were given hyperbaric oxygen treatment for 2h,3h,6h and 10h,after which,the plasma endotoxin,sCD14,EIC,TNFa and survival time in each group were examined individually.Results（1） Endotoxin and sCD14： At 3h and 6h after model had been made,the levels of plasma endotoxin and sCD14 in group D and group E were significantly lower than those in group C（P0.05）.At 3h,6h and 10h after model had been made,the levels of plasma endotoxin and sCD14 in group F were significantly lower than those in group C,group D and group E（P0.05）.（2） EIC： At 3h,6h and 10h after model had been made,the levels of EIC in group D,group E and group F were significantly higher than those in group C,group D and group E（P0.05）.the level of EIC in group F was significantly higher than that in group C and group D（P0.05）.（3） TNF-α： At 3h,6h and 10h after model had been made,the level of TNF-α in group D,group E and group F was significantly lower than that in group C（P0.05）.the level of EIC in group F was significantly lower than that in group D and group E（P0.05）.（4）Survival time： the survival time in group D,group E and group F was significantly longer than those in group C（P0.05）.the survival time in group F was longer than that in group D and group E significantly（P0.05）.Conclusions Hyperbaric oxygen or ulinastatin is individually effective in ANP,and combined hyperbaric oxygen and ulinastatin treatment is much more effective than either of them.