西维来司钠对重症急性胰腺炎大鼠胰腺外分泌功能的影响及机制研究  

Effect and mechanism of sivelestat sodium on pancreatic exocrine function in rats with severe acute pancreatitis

作　　者：龙建武[1] 李晶[2] 卢先州[1] 周筱筠[1] 徐志广[1] LONG Jian - wu;LI Jing;LU Xian - zhou;ZHOU Xiao - jun;XU Zhi - guang(a. Department of Hepatobiliary Surgery;b. Department of Endocrinology, Affiliated Nanhua Hospital, University of South China, Hengyang 421002, Hunan Province, China)

机构地区：[1]南华大学附属南华医院肝胆外科,湖南衡阳421002 [2]南华大学附属南华医院内分泌科,湖南衡阳421002

出　　处：《中国临床药理学杂志》2018年第11期1368-1370,1374,共4页The Chinese Journal of Clinical Pharmacology

基　　金：湖南省高校科研基金资助项目(12C0353)

摘　　要：目的研究西维来司钠对重症急性胰腺炎(SAP)大鼠胰腺外分泌功能的影响及其作用机制。方法将60只SD大鼠随机分为假手术组、模型组和实验组,每组20只。模型组和实验组大鼠通过向胆胰管内注入5%牛黄胆酸钠建立重症急性胰腺炎大鼠模型,假手术组仅开腹翻动十二指肠和胰腺。建模后实验组立即静脉滴注西维来司钠10 mg·kg^(-1),模型组和假手术组给予等量生理盐水。收集各组大鼠干预后胆胰液,并检测其中总蛋白、电解质及相关酶含量,检测各组大鼠血清生化指标水平,用苏木精-伊红(HE)染色法观察大鼠胰腺组织形态变化。结果药物干预后24 h,模型组大鼠死亡率为40.00%,实验组为10.00%,假手术组无死亡大鼠,实验组死亡率明显低于模型组(P<0.05)。实验组和模型组大鼠胆胰液中Ca^(2+)浓度分别为(1.88±0.41),(1.02±0.35)mol·L^(-1),差异有统计学意义(P<0.01)。实验组淀粉酶(AMS)和脂肪酶(LIP)分别为(5148.21±339.58),(673.25±185.78)U·L^(-1),模型组分别为(7752.13±674.25),(2542.36±243.25)U·L^(-1),差异均有统计学意义(均P<0.01)。药物干预24 h后,实验组大鼠血清中性粒细胞弹性蛋白酶(NE)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-8(IL-8)含量均明显低于模型组(均P<0.01)。实验组胰腺病理评分为(8.52±1.04)分,明显低于模型组的(15.56±1.22)分(P<0.01)。结论西维来司钠可降低重症急性胰腺炎大鼠死亡率,抑制胰腺分泌AMS和LIP,增加Ca^(2+)浓度,降低中性粒细胞弹性蛋白酶及炎症因子水平,进而达到治疗重症急性胰腺炎的作用。Objective To investigate the effect and mechanism of sivelestat sodium on pancreatic exocrine function in rats with severe acute pancreatitis（ SAP）,and to analyze its mechanism. Methods Sixty cases of SD rats were randomly divided into sham-operation group,model group and test group,each group 20 rats. Model group and test group were established SAP rat model by injecting 5% sodium taurocholate into bile duct and pancreatic duct,the sham-operation group was only opened the duodenum and folded the duodenum and pancreas,after modeling,test group was given intravenous infusion of sivelestat sodium 10 mg·kg^（-1）,model group and sham-operation group were given the same amount of normal saline. After intervention,the pancreatic juice were collected in all groups,the total protein,electrolyte and related enzymes were detected in the pancreatic juice of each group after intervention; serum biochemical indexes were measured in each group,hematoxylin-eosin（ HE） staining was used to observe the morphological changes of pancreas. Results Within 24 h after drug intervention,the mortality rate of model group was 40. 00%,the mortality rate of test group was10. 00%,there was no dead rats in sham-operation group,the mortality of test group was significantly lower than that of model group（ P〈0. 05）. The concentrations of Ca^（2＋）in gallbladder pancreatic juice of test group and model group were（ 1. 88 ± 0. 41）,（ 1. 02 ± 0. 35） mol · L^（-1）,with significant difference（ P〈0. 01）. The contents of amylase（ AMS） and lipase（ LIP） in test group were（ 5148. 21 ± 339. 58）,（ 673. 25 ± 185. 78） U·L^（-1）,lower than those in model group,which were（ 7752. 13 ± 674. 25）,（ 2542. 36 ± 243. 25） U·L^（-1）（ all P〈0. 01）. After 24 h of drug intervention,the levels of serum neutrophil elastase（ NE）,tumor necrosis factor-α（ TNF-α）,interleukin-2（ IL-2） and interleukin-8（ IL-8） in test group were significantly lower than those in model group（ all P�

关 键 词：急性重症胰腺炎 西维来司钠 胰腺分泌功能 

分 类 号：R97[医药卫生—药品]