摘要
目的 观察生长抑素对大鼠急性坏死性胰腺炎 (ANP)肠屏障损害和肠道内毒素移位的影响。方法 采用胰管逆行灌注法复制大鼠ANP模型 ,随机分为正常对照组 (n =6 )、假手术组(n =18)、ANP组 (n =2 0 )和生长抑素治疗组 (n =19)。观察胰腺病理、血淀粉酶、肿瘤坏死因子(TNFα)和白细胞介素 (IL) 1β、肠上皮细胞间紧密连接、肠通透性 (血浆D 乳酸 )、循环内毒素和病死率的变化。结果 生长抑素减轻了ANP早期胰腺病理改变〔8h组织学评分由 (4 2± 0 3)降至 (2 0±0 4) ,P <0 0 1〕 ;72h血淀粉酶由 (6 2 31± 44 6 1)U/L降至 (2 6 48± 1798)U/L ,P <0 0 5 ;72hTNFα由(4 7± 2 4)pg/ml降至 (2 3± 2 1)pg/ml,IL 1β由 (10 3± 40 )pg/ml降至 (5 0± 2 4)pg/ml,P均 <0 0 5 ;肠上皮细胞间紧密连接的破坏减轻 ;2 4h血浆D 乳酸由 (14 7± 4 9) μg/ml降至 (8 0± 4 2 ) μg/ml,P <0 0 1;2 4h血浆内毒素由 (0 6 11± 0 2 10 )EU/ml降至 (0 336± 0 110 )EU/ml,P <0 0 1;ANP大鼠 72h病死率由 5 9%降至 17% ,P <0 0 5。结论 生长抑素可减轻ANP大鼠的肠屏障损害 ,对肠道内毒素移位有抑制作用 ,可降低ANP大鼠的病死率。
Objective [WT5”BZ] To observe the effects of somatostatin on gut mucosal barrier (GMB) damage and endotoxemia complicating acute necrotizing pancreatitis (ANP) in rats [WT5”HZ]Methods [WT5”BZ] Murine model of ANP was produced by retrograde injection of artificial bile into the biliopancreatic duct Animals were divided randomly into (1) sham operation group, (2) ANP group (no treatment), and (3) somatostatin treatment group Morphology of pancreas and intestine and tight junction on ileum epithelia was assessed Blood amylase, cytokines (TNFα, IL 1β), endotoxin and D lactic acid were measured Mortality was compared between groups [WT5”HZ] Results [WT5”BZ] Elevation of blood amylase and cytokines was found at 8 h Necrosis and hemorrhage of the pancreas was observed accompanied by GMB and tight junction damage Plasma D lactate and endotoxin levels increased Somatostatin significantly effected a protection on pancreatic tissue (2 0±0 4) vs (4 2±0 3) of histological score, P <0 01; Serum amylase:(2?648±1?798)?U/L vs (6?231±4?461)?U/L, P <0 05;Serum TNFα: (23±21)?pg/ml vs (47±24)?pg/ml, IL 1β: (50±24)?pg/ml vs (103±40)?pg/ml,all P <0 05. Plasma D lactic acid decreased from (14 7±4 9)?μg/ml to (8 0±4 2)?μg/ml, P <0 01. Blood endotoxin level declined from (0 611±0 210)?EU/ml to (0 336±0 110)?EU/ml, P <0 01 Treatment with somatostatin significantly decreased mortality (17% vs 59%, P <0 05) [WT5”HZ] Conclusion [WT5”BZ] Somatostatin attenuates GMB damage and endotoxemia in ANP and, accordingly, could be used to improve the prognosis of ANP clinically [WT5”HZ]
出处
《中华普通外科杂志》
CSCD
2000年第12期752-754,共3页
Chinese Journal of General Surgery
关键词
胰腺炎
生长抑素
内毒素类
WT5”BZ]Pancreatitis
Somatostatin
Endotoxins
