清胰汤对急性胰腺炎肺损伤治疗作用的实验研究

[目的]探讨清胰汤在重症急性胰腺炎（SAP）急性肺损伤（ALI）时对肺表面活性蛋白A（SP-A）表达及病情转归的影响。[方法]将SD大鼠随机分为3组，各10只。假手术（对照）组仅行剖腹术，模型组采用胆胰管内逆行注入1．5％去氧胆酸钠建立大鼠SAP时ALI模型，清胰汤治疗（治疗）组在建立SAP模型后30min、12h清胰汤（10ml／kg）灌胃。各组术后24h测动脉血pH、动脉氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、血淀粉酶（AMY）、肺湿／干重（W／D）比值。应用RT-PCR检测肺sP-A mRNA的表达强度，并观察胰、肺病理变化。[结果]模型组AMY、W／D及PaCO2显著高于对照组和治疗组（均P〈0．01）。而模型组pH、PaO2显著低于其他2组（P〈0．05，〈0．01）。治疗组肺sP-A mRNA表达显著高于模型组（P〈0．01），其表达与肺损伤的程度呈负相关。治疗组胰、肺病理改变较模型组减轻。[结论]清胰汤能保护肺泡Ⅱ型上皮细胞功能，恢复SP-A mRNA正常表达，维持肺泡功能，从而对肺组织起保护作用。

Effects of Qingyitang on lung injury caused by severe acute pancreatitis in rats

[Objective]To investigate the effect of Qing yitang on acute lung injury （ALl） induced by severe acute pancreatitis （SAP）. [Methods] SD rats were randomly divided into 3 groups： sham operation group （SO,n=10）, SAP model group （SAP, n= 10）, and Qing yitang group（QYT, n= 10）. Sham operation was only made in SO. Severe acute pancreatitis was induced by retrograde injection of 1.5% deoxidat sodium cholat acid to pancreatic duct in SAP and QYT. Qing yitang（10ml/kg） was intragastricly administered 30min and 12h after SAP was induced in QYT group. Serum amylase （AMY） levels,pH, PaO2, PaCO2 and lung wet/dry ratio（W/D） were determined. SP-A mRNA expression in lung was detected by RT-PCR. The pathologic chan- ges of pancreas, lung were observed 24 h after establishment of the model. [Methods]Serum levels of AMY （7144.19±727. 91） U/L, W/D（8.57±2.45）in SAP were markably higher than that in SO（1193.41±192.54） U/L,（3. 70±0.90） and QYT （4283.51±527.52） U/L, （4.05± 0. 52） （P〈0.01）. The levels of PaO2 in SAP （79.24±5.84）mmHg were lower than that in SO （96.78±3. 81）mmHg and QYT （88. 16± 5.07） mmHg （P〈0. 05,〈0. 01）. The expression of SP-A mRNA in lung in SAP was significantly decreased than in that in SO and QYT （P〈0. 01）. The pathologic changes of pancreas,lung in QYT and SO were milder than in SAP. [Conclusion ]The expression of SP-A decreased markably in ALI induced by SAP . Administration of Qing yitang can reduce the injury of lung by restituting the expression of SP-A.