奥曲肽对急性坏死性胰腺炎肺损伤的治疗作用  

Beneficial effects of octreotide on the lung injury following experimental acute necrotic pancreatitis in rats

作　　者：王兴鹏[1] 陆琪[1] 王冰娴[1] 吴建新[1] 徐选福[1] 王国良[1] 

机构地区：[1]上海市第一人民医院消化科消化疾病研究室,200080

出　　处：《中华实验外科杂志》2000年第1期67-68,共2页Chinese Journal of Experimental Surgery

摘　　要：目的　观察奥曲肽对急性坏死性胰腺炎 (acutenecrotizcpancreatitis,ANP)大鼠肺损伤的治疗作用 ,并探讨其机制。方法　选用大鼠 63只 ,在胰胆管内注射 5 %牛磺胆酸钠溶液诱导大鼠ANP模型。观察奥曲肽对ANP大鼠肺组织形态及细胞因子变化的影响。结果　奥曲肽治疗组较ANP +NS组肺湿/干重显著降低 ,PaO2 明显提高 ,肺泡灌洗液中蛋白质含量 [奥曲肽组为 (3 3 9.9± 72 .5 )mg/L]和白细胞计数明显下降或呈下降趋势。同时 ,血浆内毒素、血清TNFα和NO2 -/NO3-水平及肺组织NOS活性显著降低 ,肺组织血管内皮细胞和导管上皮细胞一氧化氮合酶 (NOS)表达下调 ,肺组织病理学改变减轻。结论　奥曲肽对ANP大鼠并发肺损伤有一定的治疗作用 ,其机制与其对内毒素、肿瘤坏死因子 α和一氧化氮等炎症介质的调节作用有关。Objective To investigate the possible beneficial effects of octreotide on the lung injury following acute necrotizing pancreatitis (ANP) and the mechanisms. Methods The ANP model of rat was established by injection of 5 % sodium taurocholate into the choledochus. Results Octreotide could decrease Wet/dry lung ratio significantly at all indicated time point. At 12th h after induction of ANP, PaO 2, protein content in BALF, plasma endotoxin level, serum NO 2 -/NO 2 -, and NOS activity were much lower in octreotide treated rats than those in untreated group (P<0.05). Leukocyte count in BALF was also decreased with some extent but without statistical significant (P>0.05). Serum concentration of TNFα was lower dramatically in octreotide treated group than in ANP+NS group. Pathological studies showed that inflammatory cell infiltration and pulmonary interstitial edema were improved, and type II epithelial cells were well preserved in octreotide treated group. Conclusion Octreotide showed its beneficial effects on lung injury in both functional and morphologic alterations during the course of ANP. Regulatory roles of octreotide on pro inflammatory factors, such as endotoxin, TNFα, and NO could be considered as one of the major mechanisms under this situation.

关 键 词：胰腺炎 呼吸窘迫综合征 细胞因子 奥曲肽 

分 类 号：R576[医药卫生—消化系统]