吲哚美辛对重症急性胰腺炎大鼠胰腺血流和细胞凋亡的影响

Effects of Indomethacin on Pancreatic Blood Flow and Apoptosis of Pancreatic Acinar in Rats with SAP

目的 研究吲哚美辛对重症急性胰腺炎大鼠胰腺血流和细胞凋亡的影响 ,并探讨其作用机制。方法 将大鼠随机分成吲哚美辛组 (IN)、重症急性胰腺炎组 (SAP)和对照组 ,术后 12、2 4和 36h处死 ,运用多普勒超声测定胰腺局部动脉血流、门静脉血流、脾动脉血流和肠系膜上动脉血流。取大鼠胰腺病理标本 ,进行胰腺病理损害评分 ,采用TUNEL法检测胰腺腺泡细胞凋亡指数。结果 SAP时 ,大鼠胰腺局部动脉血流、门静脉、脾动脉和肠系膜上动脉的血流量明显下降 (vs对照组P <0 .0 1)。吲哚美辛明显改善了胰腺血流 ,同时改善了门静脉、脾动脉和肠系膜上动脉的血流量 (vsSAP组P <0 .0 1)。吲哚美辛治疗干预可使SAP大鼠胰腺细胞凋亡指数上升 (vsSAPP <0 .0 1) ,同时治疗组各时点胰腺病理损害较SAP组明显减轻 (P <0 .0 1)。结论 吲哚美辛能促使SAP大鼠胰腺血流量增加 ,SAP时存在着胰腺细胞凋亡 。

Purpose: To investigate the role of indomethacin on splanchnic blood flow, apoptosis of pancreatic acinar in severe acute pancreatitis(SAP) rats and underling mechanism. Methods: Fouty-eight rats were randomily divided into 2 groups: indomethacin group(IN group) and SAP group (n = 24). All groups were subdivided into 3 groups. Eight normal rats were used as controls. At 12,24,36 hours after the induction of SAP, eight rats in each group were sacrificed. The regional pancreatic micvascular blood flow was measured by Dopplar ultrasound, the blood flow of portal vein, spleen artery and superior mesenteric artery were also measured. The apoptosis of pancreatic acinar cells was detected by TUNEL method. Schmidt methed was employed to assess the pancreatic histological seventy. Results: The regional pancreatic micvascular blood flow, The blood flow of portal vein, spleen artery and superior mesenteric artery decreased in SAP group. Indomethacin increased the regional pancreatic micvascular blood flow, also increased the blood flow of portal vein, spleen artery and superior mesenteric artery(vs SAP group, P<0.01). The pancreatic aciner necrosis, hemorrhage and neatrophil infiltration decreased obviously. The apoptotic rate of pancreatic acinar in the experimental groups were much higher than that in control group(P < 0.01), IN were higher than SAP(P < 0.01). Conclusions: Enteral administration of indomethacin can increase the splanchnic blood flow in SAP rats. The apoptotic rate of pancreatic acinar is negatively correlated with the severity of disease. The interrelation between indomethacin and apoptosis in SAP is worthy of further researches.