奥曲肽干预ERCP术后胰腺炎的实验研究

Effect of octreotide administration in the prophylaxis of post-ERCP pancreatitis in animal model

目的探讨奥曲肽对兔ERCP术后胰腺炎的干预作用。方法 30只成年健康大白兔,随机分成三组:对照组(A组)、奥曲肽小剂量组(B组)、奥曲肽大剂量组(C组),每组10只,于术前30min及术后6h和12h三组分别各自皮下注射生理盐水或奥曲肽20μg/kg或100μg/kg。测定术前及术后4h及24h血淀粉酶;同时对术后24h的胰腺病理进行分析。结果术后4h,三组血淀粉酶显著升高,差异无统计学意义(P>0.05);术后24h,B﹑C组血淀粉酶有所下降,与A组血淀粉酶继续升高对比,存在显著差异(P<0.05),且B组与C组之间也存在显著差异(P<0.05);术后24h胰腺病理分析,A组胰腺组织主要表现为水肿、出血和脂肪坏死,炎症渗出和周围血管炎严重,部分可见腺泡坏死。与A组比较,B组和C组的水肿、炎症渗出和周围血管炎较轻,出血和脂肪坏死及腺泡坏死少见。结论通过在兔ERCP术后胰腺炎造模术前及术后使用奥曲肽可以减轻ERCP术后胰腺炎的严重程度,且大剂量并不能取得较好的疗效。

Objective To explore the intervention role of different doses of octreotide on experimental post-ERCP pancreatitis （PEP） in rabbit model. Methods Thirty healthy New Zealand white rabbits were ran- domly assigned to 3 groups： the control group （group A）, the lower dose octreotide group （group B）, and the higher dose octreotide group （group C）. Thirty minutes before operation and 6th, 12th hour after operation, normal saline or 20 μg/kg or 100 μg/kg octreotide were injected subcutaneously. Serum amylase was determined at 4th and 24th hour after operation, and histopathological changes of the pancreas were evaluated at 24th hour after operation. Results At 4th hour after operation, serum amylase in 3 groups was increased significantly, but there was no significant difference among them （P 〉 0.05）; serum amylase was declined in group B and C at 24th hour after operation, but increased in group A （P 〈 0.05）; 24th hour after operation, pathological examination of pancreatic tissues showed more serious edema, hemorrhage, fat necrosis, inflammatory exudation, peripheral vasculitis, and visible acinar necrosis in group A. Conclusion Octreotide administration in the prophylaxis of post-ERCP pancreatitis in animal model was effective.