乌司他丁对出血坏死性胰腺炎兔心肌缺血/再灌注损伤的保护作用  

Protective effects of ulinastain on ischemia-reperfusion injury of myocardium in rabbit model with severe acute pancreatitis

作　　者：王东 张勇刚 

机构地区：[1]河南省驻马店市中心人民医院ICU,463000

出　　处：《中国实用医刊》2010年第17期29-31,共3页Chinese Journal of Practical Medicine

摘　　要：目的 通过观察出血坏死性胰腺炎兔心肌缺血/再灌注、超氧化物歧化酶(SOD)和丙二醛(MDA)及心肌细胞凋亡的变化,探讨乌司他丁预处理对心肌缺血/再灌注损伤的保护作用.方法 逆行胰管注射5%牛磺胆酸钠溶液制作急性坏死性胰腺炎(ANP)模型.ANP兔随机分为缺血/再灌注生理盐水治疗组(C组,12只); 缺血/再灌注乌司他丁治疗组,该组共分两个亚组(U1组,12只;U2组,12只),U1组在阻断前经静脉注射乌司他丁1万U/kg;U2组在阻断前经静脉注射乌司他丁2万U/kg.每组兔均接受左冠状动脉前降支阻断60 min和再灌注180 min.分别于阻断前(T0)、阻断60 min(T1)、再灌注60 min(T2)、120 min(T3)、180 min(T4)测定血浆SOD、MDA浓度.于T4时点后立即将兔处死,TUNEL法观察兔缺血/再灌注心肌细胞凋亡的变化.结果 再灌注后180 min,U2组血浆MDA T1、T2、 T3、T4明显低于C组(P<0.05);U1组T1、T2明显低于C组(P<0.05);各组血浆SOD自T0后不同程度下降,U2组明显升高,U2组T3、T4与C组比较差异有统计学意义(P<0.05);乌司他丁治疗组心肌凋亡与C组相比明显减少(P<0.01).结论 乌司他丁对出血坏死性胰腺炎兔心肌缺血再灌注损伤有保护作用且高剂量组更为明显.Objective To study the effects of ulinastain preconditioning on ischemia-reperfusion injury of myocardium in rabbit with severe acute pancreatitis. Methods The mode of ANP was established by retrograte injection of 5% sodium taurocholate solution into the biliopancreatic duct in the rabbits. In the ANP model, Thirty-six healthy male rabbits weighed 2-2.5 kg were randomly allocated to 3 groups and 12 animals each group: The controlling group were treated with saline(group C); and group U1 and group U2 were pretreated with ulinastain(10 000 U/kg) and ulinastain(20 000 U/kg). All the rabbits in the three groups were subjected to one-hour occlusion of left anterior descending coronary artery and then three-hours reperfusion. Plasma concentrations of SOD and MDA in blood samples were measured at T0 (before occlusion), T1 (60 min after occlusion), T2(60 min after reperfusion),T3(120 min after reperfusion), T4(180 min after reperfusion),respectively. At T4, after killing all rabbits, the TUNEL method was used to examine the changing of myocardium apoptosis against ischemia-reperfusion injury. Results The plasma concentrations of MDA in group U2 at T1,T2,T3,T4 were much lower than that in group C(P＜0.05); The plasma concentrations of SOD in group U2 at T3,T4 were much higher than that in group C (P＜0.05). The apoptosis rate in group U1 was(20±6)%, group U2 was (10±3)% was lower than that in group C[(35±5)%]significantly (P<0.01). Conclusions Ulinastain preconditioning has protective effects against ischemia-reperfusion injury in rabbit with severe acute pancreatitis, especially obvious for high dose.

关 键 词：鸟司他丁 心肌缺血/再灌注损伤 心肌凋亡 

分 类 号：R57[医药卫生—消化系统]