急性坏死性胰腺炎大鼠血浆内皮素的改变及其意义

THE CHANGE AND SIGNIFICANCE OF PLASMA LEVELS OF ENDOTHELIN IN ACUTE NECROTIZING PANCREATITIS IN RATS

为了解急性坏死性胰腺炎（ａｃｕｔｅ ｎｅｃｒｏｔｉｚｉｎｇ ｐａｎｃｒｅａｔｉｔｉｓ ，ＡＮＰ） 时血浆内皮素（ｅｎｄｏｔｈｅｌｉｎ ，ＥＴ） 的变化及其病理意义，进行了前瞻性动物实验。即将ＳＤ 大鼠随机分为３ 组： 急性坏死性胰腺炎组（ ＡＮＰ 组，ｎ ＝ ２４） ，经胆胰管注入５ ％牛磺胆酸钠（ＳＴＣ，１ ｍｌ／ｋｇ） 制造ＡＮＰ 模型； 假手术组（ＳＯ 组，ｎ ＝ ２４） 和血小板激活因子拮抗剂ＢＮ５０７３９ 组（ＢＮ 组，ｎ ＝２４） 。测定血浆ＥＴ 及血小板激活因子（ｐｌａｔｅｌｅｔ ａｃｔｉｖａｔｉｎｇ ｆａｃｔｏｒ ，ＰＡＦ） 水平和胰腺微循环血流量，并进行胰腺组织病理学评分。结果： ＡＮＰ 组在诱发胰腺炎后胰腺微循环血流量立即大幅度下降，于３ 小时时有所回升，以后再持续下降。血浆ＥＴ、ＰＡＦ 水平及病理记分均显著高于ＳＯ 组。ＢＮ 组血流显著改善，血浆ＥＴ、ＰＡＦ 水平及病理记分显著低于ＡＮＰ 组。结论： 在ＳＴＣ 诱发的大鼠ＡＮＰ 发病之初，存在胰腺缺血再灌注（Ｉ／ Ｒ） 现象，导致内皮细胞损伤，血浆ＥＴ 及ＰＡＦ 增加。Ｉ／Ｒ损伤、ＰＡＦ 与ＥＴ 互相作用，形成恶性循环，加重胰腺病变。

This prospective animal study was designed to investigate the changes of plasma endothelin (ET) levels in acute necrotizing pancreatitis (ANP). Sprague Dawley rats were randomly devided into 3 groups: acute necrotizing pancreatitis (ANP) group in which ANP was induced by infusion of 5% sodium taurocholate (STC) into biliopancreatic duct, sham operation (SO) group and platelet activating factor antagonist BN 50739 (BN) group. Blood levels of ET and platelet activating factor (PAF) were detected. Pancreatic microcirculatory blood flow was measured and pancreatic histological scores were evaluated. Results showed that the pancreatic microcirculatory blood flow in ANP group was decreased to a great extent immediatly after induction of ANP and soon began to rise slowly for 3 hours and again decreased steadily after that. The blood levels of ET, PAF and histological scores in ANP group were significantly higher than those in SO group. In BN group, the blood flow was significantly improved and the levels of blood ET, PAF and histological scores were all significantly lower as compared to those in ANP group. It is concluded that ischemia/ reperfusion is present in the initiation of acute necrotizing pancreatitis induced by STC in the rat. This leads to injuries of endothelial cells and increase in the production of ET and PAF. I/R lesions,and interaction of ET and PAF lead to a vicious circle, thus augmenting the pathological changes in the pancreas.