大剂量地塞米松治疗重症急性胰腺炎的实验研究

Treatment of severe acute pancreatitis with large dosage of dexamethsone in rats

目的 观察大剂量地塞米松治疗重症急性胰腺炎 (SAP)的疗效。方法 采用经胰胆管注射 5 %牛磺胆酸制备大鼠SAP模型。随机分为 4组 :(1)A组 (n =12 ) ,SAP模型制作后 ,不经过任何治疗 ;(2 )B组 (n =10 ) ,小剂量 (0 0 5mg/ 10 0g)地塞米松 (DXM )治疗 ;(3)C组 (n =15 ) ,大剂量DXM (0 5mg/ 10 0g治疗 ) ;(4)D组 (n =6 ) ,不制作SAP型 ,开腹后翻动胰腺 ,作对照。治疗 12h后 ,测定各组血浆淀粉酶及炎症介质白细胞介素 6 (IL - 6 )、一氧化氮 (NO )、脂质过氧化物 (LPO )的水平 ,以及胰腺、肺、肾脏的病理学损害程度。结果 与小剂量DXM治疗组比 ,大剂量DXM治疗后 ,大鼠血浆淀粉酶 ,IL - 6 ,NO ,LPO均显著下降 ,生存率提高 ,平均生存时间延长 ,腹水量减少。光镜检查显示C组的胰、肺、肾的损伤程度较B组轻。结论 IL - 6 ,NO ,LPO在SAP的发生发展中有重要作用 ,大剂量DXM可以降低SAP大鼠血中的炎症介质水平 。

Objective To observe the theapeutic effects of large dosage of dexamethsone (DXM) on severe acute pancreatitis (SAP). Methods After SAP models were established in SD rats by intra-bilopancreatic duct infusion of 5% sodium taurochlate, animals were randomly divided into 4 groups: (1) Group A (n=12), no treatment was given after the SAP modol established. (2) Group B (n=10), small dosage of DXM (0.05mg/100g) treatment. (3) Group C (n=15), large dosage of DXM (0.5mg/100g) treatment. (4) Group D (n=6),SAP model was not setted up after the abdomen was opened. Plasma amylase, interleukin-6(IL-6), nitrogen oxide(NO), lipid peroxidation(LPO) were determined, and light microscopey of pancreas, lung and kidney were done 12 h after treatment. Results Comparing with small dosag DXM therapy, after large dosage of DXM therapy, the plasma amylase, IL-6, NO, LPO were decreased significantly. and the survival rate increased, the mean survival time prolonged and ascites volume decreased sig nificantly. Light microscopy found that the damage of the pancreas, lung and kidney in group C were less than those in group B. Conclusions IL-6, NO and LPO may play an important role in the development of SAP. Large dosage DXM treatment can inhibit over released inflammatory mediators in SAP.Large dosage of DXM for SAP has satisfactory effect.