奥曲肽联合灯盏花素减轻急性胰腺炎相关性肺损伤的研究

目的 通过联合应用奥曲肽和灯盏花素治疗急性胰腺炎相关性肺损伤（APALI）的动物实验,探讨其减轻急性胰腺炎和肺损伤的可能性以及作用机制.方法 建立SD大鼠APALI的实验模型,将72只SD大鼠随机分为假手术组（SO组）、急性胰腺炎组（SAP组）、奥曲肽组（O组）、灯盏花素组（B组）及奥曲肽联合灯盏花素组（OB组）,其中后4个组按照6h和12h又分别分为两个亚组,每个亚组8只SD大鼠.各组实验结束后提取血清,检测AMY、TNF-α、IL-18和IL-10的含量（ELISA法）,留取左肺组织,部分肺组织测定肺湿/干重比（W/D）,并在光镜下观察胰腺和肺组织的病理变化.结果 SAP组AMY、TNF-α、IL-18及肺W/D含量明显高于SO组,同时间O组和B组AMY、TNF-α、IL-18及肺W/D含量明显低于SAP组;同时间OB组肺组织AMY、TNF-α、IL-18明显低于O组和B组,而IL-10明显高于O组、B组;组间比较均有显著差异（P＜0.05）.病理学检查示SO组肺组织无明显损伤;各治疗组肺损伤较SAP组明显减轻,其中OB组较O组和B组减轻.结论 奥曲肽联合灯盏花素的应用比单用时能更显著的减轻胰腺和相关性肺损伤,其作用机制可能是通过抑制IL-18和TNF-α等炎症介质的活性和升高IL-10抗炎细胞因子而实现的.

Research of Protective Effect of Octreotide and Breviscapine on Acute Pancreatitis Associated Acute Lung Injury

Objective To investigate the protective effect of octreotide and breviscapine on acute pancreatitis - associated lung injury and explore the possible mechanisms of reducing acute pancreatitis and lung injury. Methods 72 SD rats were randomly divided into 5 groups ： shame operation group （ SO）, SAP group （ SAP）, octreotide group （ O ）, breviscapine group （ B ） and octreotide ＋ breviscapine group （ OB）, and each group was divided into 6h and 12h sub - group again. APALI model was induced by retrogradely injection of sodium deoxy- cbolate. After 6 hours and 12 hours, lung wet/dry weight ratio, pathological changes of pancreas and lung, and the expression of serum AMY,TNF - α, IL - 18 and IL - 10 was detected by ELISA. Results The lung wet/dry weight ratio, the serum concentration of AMY, TNF - α, IL - 18 and IL - 10 increased significantly in two SAP groups compared with S group during the same period （ P 〈 0.05 ）. The lung wet/dry weight ratio, the serum concentration of AMY, TNF -α and IL - 18 decreased significantly in each therapy group compared with the SAP groups during the same period. Compared with O or B group,in OB group the serum concentration of AMY, TNF - α, IL - 18, lung wet/dry weight ratio apparently decreased （ P 〈 0.05 ）. The serum concentration of IL - 10 increased significantly in each therapy group compared with the SAP group during the same period. In OB group, the level of serum IL - 10 increased more significantly than O or B group. Histological examination showed that the lung injury in group OB was less than that in O or B groups. Conclusion Octreotide or breviscapine could relieve the degree of SAP associated lung injury, and better effect can be got, if they are used by associated octreotide with breviscapine.