急性坏死性胰腺炎并发肾损害的机制及对丹参的效应

目的　探讨急性坏死性胰腺炎 (acutenecrotizingpancreatitis,ANP)时肾微循环改变对肾损害的影响及其丹参的干预效应。方法　SD大鼠 96只 ,随机分为对照组 (C)、胰腺炎组 (P)和治疗组 (T)。5 %牛磺胆酸钠胰腺被膜下均匀注射制作ANP模型。采用放射生物微球法测定制模后 2h和 12h的肾组织血流量 ,同时观察肾静脉血磷脂酶A2 (PLA2 )、血栓素A2 (TXA2 )与前列环素 (PGI2 )比值、肾组织中性白细胞浸润情况及肾功能和肾组织学改变。结果　与C组比较 ,P组在制模后 2h及 12h肾组织学损害及肾组织中性白细胞浸润明显加重 (P <0 0 0 1) ,肾血流量明显降低 (P <0 0 5 ) ,PLA2 活性、TXA2 /PGI2 、BUN及Cr水平明显增高 (P <0 0 5 )。与P组比较 ,制模后 2hT组除中性白细胞计数减少外 (P <0 0 0 1) ,上述指标差异无显著意义 ;12h肾血流量显著增高 (P <0 0 1) ,PLA2 、TXA2 /PGI2 、BUN、Cr显著降低 (P <0 0 5 ) ,肾组织中性白细胞浸润明显减轻 (P <0 0 0 1) ;2h及 12h肾组织学损害均明显减轻 (P <0 0 5 )。结论　肾损害在ANP早期即发生 ,肾脏微循环障碍及相关炎症介质的升高是肾损害的重要原因 ,丹参对ANP肾损害具有保护作用。

The effect of labiatae on renal injury in rats with acute necrotizing pancreatitis

Objective To explore the effects of labiatae on changes of renal injury and renal microcirculation in rats following acute necrotizing pancreatitis(ANP).Methods A total of 96 rats were randomly divided into control goup(C),pancreatitis group(P) and treatment group(T).The model of ANP was established by injection of 5% sodium taurocholate into the pancreatic capsule.Radioactive biomicrosphere technique was used to measure the blood flow of kindney at 2 h and 12 h after induction of ANP,meanwhile,blood samples and renal tissues were collected to observe the changes of renal function,PLA 2 activity,TXA 2/PGI 2,number of neutrophils infiltrating the kidney, and renal histology.Results Comparing with group C,the renal pathological changes were significant(P<0 001),renal blood flow was dereased significantly(P<0 05),the number of neutrophils,PLA 2 activity,TXA 2/PGI 2,BUN and Cr levels were elevated significantly(P<0 05) at 2 h and 12 h after ANP in group P.Contrast with group P,the renal pathological changes and neutrophils infiltration were alleviated sigificantly(P<0 05) at 2 h and 12 h in group T.The blood flow of kidney was elevated(P<0 01),PLA 2,TXA 2/PGI 2,BUN and Cr were decreased significantly(P<0 05) at 12 h after ANP in group T.Conclusion Renal injury is found early in ANP,the renal microcirculation disorder and increase of circulation inflammatory mediators may be important causes of renal injury in ANP.labiatae can protect the kidney from such injuries. [