两种途径应用乌司他丁治疗重症急性胰腺炎的实验研究

Experimental study on two treatment ways of severe acute pancreatitis with ulinastatin

目的比较腹腔灌洗与静脉输入乌司他丁(UTI)治疗重症急性胰腺炎(SAP)大鼠的疗效。方法 Wistar大鼠60只随机分为3组,每组各20只:SAP模型组(逆行胰管注射5%牛磺胆酸钠)、UTI静脉组(SAP模型建立后予以尾静脉注射UTI)、腹腔灌洗组(SAP模型建立后予以UTI腹腔灌洗)。各组在治疗6 h、24 h后,分别检测血(TNF-α、IL-1β)、腹水(脂肪酶、淀粉酶)、胰腺(NF-κB及病理检查)。结果无论从胰腺本身病理改变、腹水胰酶水平、血液中炎症因子水平,还是胰腺组织中NF-κB水平,两种途径使用UTI都取得明显效果,但是腹腔灌洗组的效果优于静脉组。结论在SAP的治疗中,UTI早期腹腔灌洗比静脉应用疗效更好。

Objective To make comparison of curative effects between peritoneal lavage and intravenous infusion with ulinastatin （UTI） on rats with severe acute pancreatitis. Methods Sixty Wistar rats were randomly divided into 3 groups with 20 ones in each group, i. e. SAP model group （retrograde injection via pancreatic duct with 5% taurocholate sodium）, UTI intravenous injection group （injection via tail vein with UTI after the establishment of SAP model）, and peritoneal lavage group （peritoneal lavage with UTI after the establishment of SAP model）. The levels of TNF-α, IL-1β, lipase, amylase, and NF-κB and the examination resuhs in each group were detected 6 and 24 h after the treatment. Results The two treatment ways with UTI both had obvious effects on pathological changes of pancreatic gland, pancreatic enzyme level in ascites,inflammation factor level in the blood, and NF-κB level in the pancreatic tissues. But the effects in the peritoneal lavage group were better than those in the intravenous infusion group. Conclusion In the treatment of SAP, the early peritoneal lavage with UTI can achieve better curative effect than intravenous injection.