内毒素在急性出血坏死性胰腺炎病程中的作用及白细胞介素-2的治疗作用

为观察内毒素在急性出血坏死性胰腺炎（ ＡＨＮＰ） 病程中的作用，并探讨重组人白细胞介素２（ＩＬ２） 的治疗作用，应用５ ％ 牛磺胆酸钠经胰胆管逆行注射制作大鼠ＡＨＮＰ 模型，并用ＩＬ２ 进行实验性治疗。结果： ＡＨＮＰ 组内毒素含量明显增高，并伴随血浆胰酶活性显著增高，且随病程的延长两者呈进行性增高，胰腺组织学改变也呈进行性加重；ＩＬ２治疗组的血浆内毒素水平及胰腺组织学改变却有显著改善，７２ 小时病死率由６６ ．７ ％ 降低至２６ ．７ ％ （ Ｐ＜ ０ ．０１） 。提示内毒素是加重ＡＨＮＰ 的重要因素，ＩＬ２ 能改善内毒素血症，对ＡＨＮＰ 有一定的治疗作用。

THE ROLE OF ENDOTOXIN ON EXPERIMENTAL ACUTE HEMORRHAGIC NECROTIC PANCREATITIS AND THERAPEUTIC EFFECT OF INTERLEUKIN-2

To study the role of endotoxin in acute hemorrhagic necrotizing pancreatitis (AHNP), the change of endotoxin were studied in rats AHNP models by injection of 5% sodium taurocholate 1 ml/kg into pancreatic duct, and the effects of recombinant interleukin 2 (IL 2) in the treatment of AHNP were observed in this experiment. The results indicated that endotoxin involved the aggravation of AHNP and was associated with the increase of serum phospholipas 2 (PLA 2), and these mediators were positively correlated with severe degrees of pancreatic damage. The results also suggeste that IL 2 might inhibit the overexpression of endotoxin and PLA 2 and mitigate the pancreatic injury and decrease the 72h mortality rate of AHNP from 66.7% to 26.7% ( P <0.01). Endotoxin might play a major role in the pathogenesis of AHNP and IL 2 might have a potential role in the treatment of AHNP.