生长抑素区域动脉灌注对重症急性胰腺炎大鼠肠黏膜屏障的保护作用

【目的】探讨生长抑素区域动脉灌注对重症急性胰腺炎（SAP）大鼠肠黏膜屏障的保护作用及机制。【方法lSD大鼠60只，随机分为假手术组（A组），SAP组（B组），生长抑素外周静脉注射组（C组），生长抑素区域动脉灌注组（D组）。测定各组大鼠的血清淀粉酶（Amy），各组动物血中白细胞介素-1（IL-1）、白细胞介素-6（IL-6）和肿瘤坏死因子-a（TNF-a）的含量，观察小肠病理损害及肠黏膜上皮细胞凋亡的情况。【结果】①制成SAP模型后，各组Amy、IL-1、IL-6、TNF-a的含量水平显著上升，生长抑素治疗后可使Amy、IL-1、IL-6、TNF-a的含量下降，其中生长抑素区域动脉灌注组下降更为明显。②生长抑素治疗后小肠病理损害评分及细胞凋亡指数均下降（P〈0．05），生长抑素区域动脉灌注组作用更强。【结论】①sAP时，应用生长抑素可以减轻sAP时肠黏膜的损伤，对肠黏膜屏障具有一定的保护作用，其机制可能与降低血中IL-1、IL-6、TNF-a的含量，抑制肠黏膜上皮细胞的过度凋亡有关。②区域动脉灌注是治疗SAP的增效途径。

Protective Effect of Regional Intra-arterial Infusion with Somatostatin on Intestinal Mucosal Barrier of Rats with Severe Acute Pancreatitis

[Objective] To explore the protective effect of regional intra-arterial infusion with somatostatin on intestinal mueosal barrier of rats with severe acute pancreatitis（SAP） and its mechanism. [Methods] Sixty SD rats were randomly divided into Sham-operative group（group A）, SAP group（group B）, group of periph eral vessel infusion of somatostatin（group C）, group of regional intra-arterial perfusion of somatostatin（group D）. Serum amylase（Amy）, interleukin-l（IL-1）, interleukin-6（IL-6） and tumor necrosis factor-alpha（TNF-a） in blood of each group were measured. Pathological lesion of small intestine and the apoptosis of intestinal epi- thelium mucosa were observed. [Results] After the establishment of SAP model, the levels of Amy, IL-1, IL- 6 and TNF-a in each group increased obviously. The treatment with somatostatin could decrease the levels of Amy, IL-1, IL-6 and TNF-a. The levels of above indexes in the group 6f regional intra-arterial perfusion of somatostatin decreased more markedly. After treatment with somatostatin, the pathological lesion score of small intestine and cell apoptotic indexes reduced（ P 〈0.05）, and those in the group of regional intra-arterial perfusion of somatostatin declined more obviously. [Conclusion] Somatostatin can alleviate SAP-induced injury of intestine mucosa and protect the intestinal mucosal barrier, which the mechanism may be related with the decreasing of blood IL-1, IL-6 and TNF-a and the inhibition of excessive apoptosis of the intestine mucosa. Regional intra-arterial perfusion is one of the means of improving the therapeutic effect of drugs against SAP.