糖皮质激素对急性胰腺炎脑损伤治疗作用的实验研究

目的 应用十二指肠置管结扎法制作大鼠急性重症胰腺炎(severe acute pancreatitis,SAP)模型,研究糖皮质激素(glucocorticoids,GC)对急性胰腺炎脑损伤的治疗作用.方法 32只Wistar大鼠随机分为正常对照组(A组)、急性胰腺炎组(B组)、颈总动脉治疗组(C组)和侧脑室治疗组(D组),行十二指肠置管结扎术制成SAP模型,实验动物处死后,测量脑组织含水量,胰腺和脑组织进行HE染色,脑组织样本进行TNF-α、IL-2的免疫组化染色和髓鞘特殊染色,进行胰腺病理损害评分和脑微血管白细胞计数.结果 经糖皮质激素治疗后,脑水肿、白细胞计数及有髓神经脱髓鞘均减轻,差异有显著统计学意义(P＜0.05).结论 糖皮质激素对急性胰腺炎脑损伤有预防和治疗作用.

Therapeutic effects of glucocorticoids on brain damage due to acute pancreatitis

Objective To investigate the therapeutic effects of glucocorticoids(GC)on brain damage in rats with severe acute pancreatitis(SAP).Methods Thirty two rats were randomized into the normal control group(Group A),acute pancreatitis group(Group B),common carotid therapeutic group(Group C)and lateral ventricle therapeutic group(Group D).The rats in group C and D were respectively given methylprednisolone through common carotid artery and lateral ventricle. All rats were killed 24r h later to determine the weight of water content in the brain.The pancreatic and brain tissues were stained with HE.Meanwhile,the brain samples were immunohistochemically stained and the medulla sheath specially stained to determine TNF-α and IL-2.Histopathological scoring of pancreas and counting of leukocytes in the brain were conducted.Results Group A had no obvious pathologic changes.Group C and D had fewer TNF-α positive cells in the brain than Group B.IL-2 was negative in each group.Brain edema,leukocyte number and demylination of myelinated nerves in Group C and D were significantly different from those in Group B(P＜0.05).Conclusion Demylination of myelinated nerves is the characteristic change in SAP.Brain edema,leukocyte infiltration and nerve cell degeneration would happen as well.TNF-α plays an important role in the development of SAP.GC has effects on prevention and therapy of brain damage in rats with SAP.