早期应用虎杖甙治疗重症急性胰腺炎的机制探讨  

The mechanism of the intervention effect of polydatin in the treatment of the rats with severe acute pancreatitis

作　　者：朱椰凡[1] 王津道[2] 张启瑜[1] 王晓蓉[1] 孙运鹏[1] 

机构地区：[1]温州医学院第一附属医院肝胆外科,浙江温州325027 [2]绍兴市人民医院普外科,浙江绍兴312000

出　　处：《肝胆胰外科杂志》2009年第6期460-463,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：温州市科技局资助项目(Y20060223);浙江省中医药管理局资助项目(2006C097)

摘　　要：目的探讨早期应用虎杖甙(polydatin,PD)在治疗重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠中的作用及其可能的机制。方法将SD大鼠随机分成对照组、SAP模型组和PD治疗组。各组模型制备成功后6h,分别采集各组大鼠静脉血液标本和胰腺组织,采用酶联免疫吸附(ELISA)方法分别检测血液中内皮素-1(ET-1)和细胞间黏附分子-1(ICAM-1)的表达量,并检测血淀粉酶(AMY),光镜下观察胰腺组织病理改变,透射电镜观测胰腺细胞内超微结构的病理变化。结果与对照组比较,SAP模型组和PD治疗组血中AMY、ET-1、ICAM-1浓度均有明显升高(P<0.01);而PD治疗组的血中AMY、ET-1浓度与SAP组比较有明显下降(P<0.01)。胰腺组织的病理变化:相对于对照组,PD治疗组和SAP模型组光镜下可见胰腺细胞坏死、微血管出血等病理改变,电镜下胰腺细胞内各细胞器均有不同程度结构、功能改变;而PD治疗组胰腺病理变化比SAP模型组明显减轻。结论早期应用PD对治疗急性胰腺炎具有一定的作用。其作用机制可能是:PD通过抑制SAP大鼠血液中ET-1的表达,阻止微血栓形成;进而改善胰腺微循环,减轻胰腺组织病理损伤。Objective To investigate the role and its possible mechanism of polydatin （PD） in the treatment to the rats with severe acute pancreatitis （SAP）. Methods Healthy male SD rats were randomly divided into three groups： the control group, the severe acute pancreatitis group and the PD treated group. Six hours later after the three groups of model were successfully established, the venous blood and specimens of the pancreatic tissue were collected from the rats. The serum amylase was determined with routine method and the concentration of ET-1 and ICAM-1 was determined with the method of enzyme-linked immunosorbent assay （ELISA） in the venous blood. Pathological changes of the pancreas were observed under optical microscope with hematoxylin-eosin （HE） staining and the pathological changes in the ultrastructure of pancreatic cells were observed under transmission electron microscope. Results Compared with the control group, the concentration of AMY, ET-1 and ICAM-1 was significantly increased （P〈0.01） in SAP group and PD group. While the concentration of AMY, ET-1 in PD group obviously descended compared with the SAP group （P〈0.01）. Compared to the pathological changes of the specimens of pancreatic tissue in the control group, necrosis of pancreatic cells and microvascular bleeding could be seen in PD group and SAP group under the optical microscope. Under the electron microscope, there were structural and functional changes in pancreatic cells in the PD group and the SAP group, but the changes lessened in the PD group. Conclusion The application of PD in earlier period can play definite role for the treatment of acute pancreatitis. Its possible mechanisms maybe that PD can prevent from the formation of microthrombus through inhibiting the expression of ET-1 in blood of SAP rat, thus improve the pancreatic tissue microcirculation, reducing the pathological damage of the pancreatic tissue.

关 键 词：虎杖甙 重症急性胰腺炎 内皮素-1 细胞间黏附分子-1 大鼠 

分 类 号：R285.5[医药卫生—中药学]