生长抑素和生长激素联合治疗对急性坏死性胰腺炎转归作用的初探  

Curative effect of somatostatin combined with growth hormone on outcome of acute necrotizing panceatitis

作　　者：张群华[1] 倪泉兴[1] 蔡端[1] 张延龄[1] 姜永锋[1] 吴树强[1] 向阳[1] 殷保兵[1] 张妞[1] 侯兰娣[1] 

机构地区：[1]上海医科大学附属华山医院外科,200040

出　　处：《中华肝胆外科杂志》1998年第5期289-292,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的研究生长抑素和生长激素联合治疗对急性坏死性胰腺炎(ANP)的转归作用。方法经胰胆管逆行注射3.5%牛磺胆酸钠2.5 ml/kg 建立鼠 ANP 模型,测定血清 IL-8、IL-6、TNF-α、淀粉酶、内毒素和白蛋白。胰腺、肝、心、肺和肾病理观察及细胞超微结构观察,TNFα-mRNA 分子转录水平的 RT-PCR 分析及 TNFα的免疫组化原位观察,探讨生长抑素和生长激素治疗作用。结果ANP 的发生和发展伴有炎性介质的明显升高,与 ANP 和 MODS 的发展呈正相关。生长抑素和生长激素对抑制炎性介质的释放和 TNFα-mRNA 过度表达有协同作用,同时亦表明肝脏在 ANP 中对预防宿主多器官衰竭有重要作用。结论 TNFα-mRNA 的高度表达在 ANP 的进展中至关重要,生长抑素和生长激素的联合治疗对防治 MODS 的发生和防治有重要作用。Objective To evaluate the effect of somatostatin and growth hormone on outcome of acute necrotizing pancreatitis(ANP).Methods A rat ANP model was made by retrograde injection of 3.5% sodium taurocholate at 2.5ml/kg into the pancreatic duct.Serum IL-8,IL-6,TNFα,amylase, endotoxin and albumin were determined.Microscopy of the pancreas,liver,lung,heart and kidney as well as the eleetronmicroseopy of liver,lung and heart cells were carried out.Finally TNFα mRNA in the liver and pancreas after ANP was determined by reverse transeriptase polymerase chain reaction, and TNFα of lung and pancreas was subjected to immunohistoehemieal staining.Efficacy of somato- statin and growth hormone was also observed in this experiment.Results ANP resulted in remarkable elevation of those inflammatory mediators which were positively correlated with development of ANP and MODS.Somatostatin and growth hormone had synergetic effect on release of inflammatory media- tors and overexpression of TNFα mRNA.The liver could play an important role in protecting the host from multiple organ failure.Conclusions It is concluded that TNFα mRNA plays an important role in ANP progression and somatostatin and growth hormone may be the effective treatment to prevent from development and progression of MODS on ANP.

关 键 词：ANP 生长抑素 联合治疗 急性坏死性胰腺炎 TNFα 生长激素 转归 RNA分子 转录水平 RT-PCR分析 

分 类 号：R657.51[医药卫生—外科学] R576[医药卫生—临床医学]