前列腺素E1治疗大鼠胰腺炎肺损伤的作用机制

目的: 探讨急性胰腺炎肺损伤的发病机制及前列腺素E1(PGE1)的治疗作用 。方法: 制成十二指肠盲袢并注入5%牛磺胆酸钠溶液,建立胰腺炎肺损伤模型,并连续输注PGE1 。结果: 胰腺炎时,血淀粉酶升高,肺湿重及肺毛细血管通透性增加,肺组织中性粒细胞髓过氧化酶(MPO)、脂质过氧化物(LPO)和磷脂酶A2(PLA2)活性增加。病理显示肺水肿,中性粒细胞(PMN)浸润。肺泡内渗液、出血,肺泡萎陷。胰腺损伤程度与肺损伤程度显著正相关。PGE1可降低肺毛细血管通透性及肺湿重,可使肺MPO、LPO和PLA2显著下降。肺以间质水肿、PMN浸润为主。肺泡渗液、出血减轻。PGE1未能使胰腺损伤减轻 。结论: ①急性胰腺炎常合并肺损伤。②中性粒细胞活化,氧自由基大量释放及PLA2活性增强,在肺损伤中发挥了重要作用。③PGE1可通过抑制PMN活化,减少氧自由基释放,降低PLA2活性,使肺损伤减轻。

The mechanism of prostaglandin E1 in the treatment of pancreatitis associated acute lung injury of rats

Objective：To investigate the mechanism of panreatitis associated aute lung injury and the effect of prosta-glandin E1(PGE1).Methods：The model of acute necrotizing pancreatitis(ANP)-associated acute lung injury was induced by infusion of 5% sodium taurocholate into the duodenal loop of rats. PGE1 was infused continuously from cervical vein.Results：It was showed that the pulmonary wet wieght and capillary permeability,the activity of myeloperoxidase(MPO) and phospholipase A2(PLA2) in lungs,the levels of Lipoperoxides(LPO) in lungs and amylase inserum significantly increased during ANP. The lung injury was described as pulmonary edema, polymorphonuclear cell(PMN) infiltration,intra-alveolar hemorrhage,etc.. There was an affirmative connection between pancreas and lungs in the damage severity. The treatment by PGE1 ameliorated the above-mentioned adverse pathophysiological changes seen in control.Conclusion：①ANP usually induces acute lung injury.②PMN,Oxygen-free radical and PLA2 play a role in the aucute lung injury.③PGE1 may reduce the severity of lung injury by inhibiting PMN activation,releasing oxygen free radical and PLA2 activity.