急性坏死性胰腺炎生长抑素和生长激素联合治疗对多器官损伤的保护作用  

Somatostatin and growth hormone protection on multiple organ injury in acute necrotizing pancreatitis

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] 段保兵 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

出　　处：《世界华人消化杂志》1998年第S2期185-188,共4页World Chinese Journal of Digestology

摘　　要：目的研究生长抑素和生长激素联合应用防治急性坏死性胰腺炎（ANP）的全身炎症反应综合征和多器官功能障碍综合征及其治疗策略．方法经胰胆管逆行注射35g／L牛磺胆酸钠2．5mL／kg建立鼠ANP模型．测定血清IL-8，IL-6，TNFα,淀粉酶、内毒素和清蛋白．胰腺、肝、心、肺和肾病理观察及细胞超微结构观察，TNFαmRNA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递质的明显升高，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递质的释放和TNFarnRNA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TNFαmRNA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时防治ANP的MODS的发生和防治有重要作用.AIM To study the protective role of somatostatin and growth hormone on systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in acute necrotizing pancreatitis (ANP), and evaluate the procession from SIRS to MODS and therapeutic strateqies in ANP.METHODS Rat ANP models were made by retrograde injection of 35 g/ L sodium taurocholate 2 .5 mL/ kg into the pancreatic duct. Serum IL-8, IL-6, TNFα, amylase,endotoxin, and albumin were examined. The morphology and pethology of the pencreas, liver, lung, heart, and kidney as well as the electronmicroscopical investigation of liver, lung and heart cells were observed. Finally TNFαmRNA in the liver, lung, kidney and heart after ANP were oberved by reverse transcriptase-polymerse chain reaction, and TNFαof lung, pancreas, and heart were performed by immunohistochemical staining. Efficiency of somatostatin and growth hormone were also oberved in this experiments.RESIJLTS ANP developed with remarkable elevation of inflammatory mediators which are positively correlated with the development of ANP and MODS, indicating that the liver may play an important role in protecing the host from multiple organ failure.CONCLUSION TNFαmRNA has an important role in ANP progression and somatostatin and growth hormone may be the effedtual treatment to prevent the development and progression of MODS in ANP.

关 键 词：胰腺炎/药物疗法 多器官损伤/药物疗法 急性病 生长抑素/治疗应用 生长激素/治疗应用 

分 类 号：R576[医药卫生—消化系统]