生长抑素与清胰汤对急性重症胰腺炎大鼠的作用机制  

Study on the therapeutic effect of combination of somatostatin with qingyitang in treatment of severe acute pancreatitis

作　　者：张国顺[1] 张文缓 赵华[3] 马利转 王玉兰[1] 徐晓平[1] 李玉林[1] 

机构地区：[1]河北联合大学附属医院(原华北煤炭医学院附属医院)消化内科,河北唐山063000 [2]武警河北总队医院唐山分院 [3]河北医科大学第一医院消化内科

出　　处：《现代预防医学》2013年第5期911-913,918,共4页Modern Preventive Medicine

基　　金：唐山市科技攻关指令项目(10150204A-37)

摘　　要：目的观察生长抑素联合清胰汤对急性重症胰腺炎模型大鼠血ET、NO、ET/NO和TXA_2、PGI_2、TXA_2/PGI_2的变化,探讨生长抑素、清胰汤对大鼠急性重症胰腺炎的作用机制,为临床应用提供依据。方法 SD大鼠90只,体重(271.59±11.13)g,雄性,常规适应性喂养1周,实验前12h禁食,自由饮水。随机分成5组:假手术组(NC);急性重症胰腺炎(SAP)组;清胰汤治疗组(QY);生长抑素治疗组(SZ);联合治疗组(LH);每组18只。并将各组随机分成6h、12h、24h3个亚组,每个亚组6只。SAP模型组经胰胆管逆行注入5%牛磺胆酸钠(0.1ml/100g),假手术组胰胆管不穿刺、注药,仅翻动胰腺;生长抑素治疗组、清胰汤治疗组、联合治疗组的大鼠分别于造模成功即刻、5h、11h给予生长抑素(1μg/100g)背部皮下注射、清胰汤(1ml/100g)灌胃及两药联合治疗。动态观察记录各组及亚组(6h、12h、24h)Amy(淀粉酶测定速率法)、NO(硝酸还原酶法)、ET(放射免疫测定法)、TXA_2(放射免疫测定法)、PGI2(放射免疫测定法)含量。结果与假手术组比较,急性重症胰腺炎组各时间点血清AMY、NO、ET、TXB2值明显升高;ET/NO、TXB2/6-Keto-PGF1a比值明显升高;差异有统计学意义(P﹤0.01);与SAP组比较,生长抑素治疗组、清胰汤治疗组血清AMY、NO、ET、TXB2、6-Keto-PGF1a值降低,AMY、ET、TXB_2与SAP组比较差异有统计学意义(P﹤0.01);ET/NO、TXB_2/6-Keto-PGF1a比值降低;与清胰汤治疗组、生长抑素治疗组比较,联合治疗组血清AMY、ET、TXB2降低;差异有统计学意义(P﹤0.05);ET/NO、TXB_2/6-Keto-PGF1a比值降低趋于平衡(P﹤0.05)。结论 SAP时,NO、ET、TXB_2、6-Keto-PGF1a参与病变的发生发展过程,说明NO、ET、TXB_2、6-Keto-PGF1a是微循环变化的重要介质。OBJECTIVE To investigate the effects of combination of somatostatin with qingyitang on severe acute pancreatitis of SD-rats. To detect serum concentrations of ET, NO, TXA2, PGI2, ET/NO, TXA2/PGI2; To find the mechanism of somatostatin and qingyitang on severe acute pancreatitis, to provide theoretic evidence for clinic application. METHODS Elucidated the mechanisms of microcirculatory disturbance in rats with severe acute pancreatitis and the therapeutic effectiveness of somatostatin and qingyitang; ninety SD-rats were selected and divided randomly into five group （with 18 in each） ： including sham operation group （NC）, severe acute pancreatitis group （SAP）, somatostatin treated group （SZ）, qingyitang treated group （QY）, somatostatin associate qingyitang treated group （LH SZ＋QY）. And then eighteen rats in each group were divided randomly into three group： 6h, 12h, 24h （six rats in each of the above groups）. Severe acute panereatitis was induced by 5% sodium taurocholate through pancreatic duct retrograde injection in SD-rats in SAP model group, NC group did not inject sodium tauroeholate, only turned over pancreas. SZ group, QY group and LH group were subcutaneously injected with somatostatin （1 Ixg/100 g）, qingyitang perfusion （I ml/100 g） and combination of somatostatin with qingyitang, respectively when immediately, 5 hours later and 11 hours later injection. The serum concentrations of endothelin （ET） , nitric-oxide （NO） , thromboxaneA2 （TXA2） and prostaglandin 12 （PGI2） were measured 6 hour, 12hour 24hour after induction of SAP respectively. RESULTS Comparison with NC group, the AMY, NO, ET, TXB2, ET/NO, TXBJ6-Keto-PGFla levels in SAP group increased obviously （P 〈 0.01） ; Compared with SAP group, AMY, NO, TXB2, 6-Keto-PGFla levels in SZ, QY, LH group decreased, AMY, ET, TXB2 had obvious differences （P 〈 0.01） ; ET/NO, TXBJ6-Keto-PGFla in SZ, QY, LHgroup obviously decreased （P 〈 0.01） ; Compared with SZ, QY group, AMY, ET, TXB2 level

关 键 词：急性重症胰腺炎 生长抑素 清胰汤 实验研究 

分 类 号：R657.51[医药卫生—外科学]