地塞米松治疗急性坏死性胰腺炎的实验研究  

Experimental Study on the Treatment of Acute Necrotizing Pancreatitis by Dexamethasone

作　　者：杨植[1] 刘东坡[1] 王晓杰[1] 张秀芹[1] 赵晓明[1] 李民[1] 杨曙光[1] 

机构地区：[1]承德医学院附属医院普外科,承德067000

出　　处：《中国普外基础与临床杂志》2002年第1期26-27,共2页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的　探讨地塞米松治疗急性坏死性胰腺炎 (ANP)的机理。方法　经胰胆管逆行注射牛磺胆酸钠法诱导SD大鼠ANP ,治疗组 (n =2 4)模型诱导 30min后注射地塞米松 0 .2mg/10 0g鼠重 ,对照组 (n =2 4)注射等量生理盐水 ,两组分别于 4h和 12h各处死 8只鼠测血清肿瘤坏死因子α(TNFα)、淀粉酶 ,并行胰腺坏死程度评分、检测胰腺腺胞细胞凋亡 ,余下 8只鼠作生存期观察。结果　治疗组 4h、12hTNFα分别为 ( 17.8± 2 .7) pg/ml和 ( 8.5± 1.6 )pg/ml,胰腺腺胞细胞凋亡指数分别为 ( 36 .94± 4.12 ) %和 ( 32 .79± 3.31) % ,生存时间为 ( 33.4± 2 1.5 )h ;对照组上述各项指标依次为 ( 5 3.6± 18.7)pg/ml和 ( 37.2± 11.1) pg/ml (P<0 .0 1)、( 4 .37± 1.2 4) %和 ( 5 .12± 2 .11) % (P<0 .0 1)及 ( 14 .6± 5 .7)h (P<0 .0 1) ,两组胰腺坏死程度评分差异有显著性意义 (P<0 .0 1)。结论　地塞米松能通过抑制TNFα调控细胞凋亡 ,细胞凋亡对胰腺具有保护作用。Objective To investigate the mechanism of dexamethasone in the treatment of acute necrotizing pancreatitis (ANP). Methods The ANP of 48 SD rats were induced by retrograde infusion of sodium taurocholate through biliopancreatic duct.After 30 minutes,the therapy group was administrated with dexamethasone at a dose of 0.2 mg/100 g alone . The control group was administrated with the same amount of 0.9% saline solution.At fourth hour and twelfth hour,8 rats of each group were sacrificed to examine the levels of serum tumor necrosis factor alpha(TNFα) and serum amylase,to score the degree of pancreatic necrosis and to evaluate acinar cell apoptosis by in situ hybridization by terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling(TUNEL). The survial period of 8 rats in each group were observed. Results In therapy group, the level of TNFα was (17.8±2.7) pg/ml and (8.5±1.6) pg/ml,the apoptosis index was (36.94±4.12)% and ( 32.79±3.31)%,the survival period was (33.4±21.5) h.While the control group with the indexes mentioned above were as follows: (53.6±18.7) pg/ml and (37.2±11.1) pg/ml ( P <0.01), (4.37± 1.24)% and (5.12± 2.11) % ( P <0.01),(14.6±5.7) h ( P <0.01) ,the histologic scoring for ANP between therapy group and control group was a significantly distinct ( P <0.01). Conclusion Dexamethasone can induce pancreatic acinar cell apoptosis in this model. Proper leves of TNFα may play an important role in regulating the apoptosis.Apoptosis can protect pancreas from necrosis in ANP.

关 键 词：地塞米松 急性坏死性胰腺炎 细胞凋亡 肿瘤坏死因子Α 

分 类 号：R657.51[医药卫生—外科学]