CAJ | 학술논문

目的探讨牛磺胆酸钠诱导急性坏死性胰腺炎(ANP)并发多器官功能衰竭(MODS)大鼠模型的量-效关系及理想浓度.方法 280只大鼠按数字随机法分为对照组(40只)和ANP组,分别采用经胰胆管逆行注射3.5%、4%、4.5%、5%牛磺胆酸钠制备ANP模型(每浓度组60只).术后1、3、6、12、24 h分批处死大鼠,检测血清淀粉酶、总胆红素、肌酐水平,行血气分析,常规胰腺病理检查并评分;各ANP组另留20只大鼠观察建模后24 h生存率.结果各ANP组的血清淀粉酶、总胆红素、肌酐水平及氧合指数(PaO_2/FiO_2)、胰腺病理评分均随牛磺胆酸钠浓度增加而升高,呈明显的量-效和时-效关系.4.5%牛磺胆酸钠建模组于术后6 h出现肝、肾功能障碍高峰,12 h出现呼吸功能障碍高峰,其MODS发生率为52.5%,显著高于3.5%、4.0%牛磺胆酸钠建模组的15.0%和37.5%;24 h生存率为65%,显著高于5%牛磺胆酸钠建模组的30%.结论 4.5%牛磺胆酸钠诱导ANP大鼠模型具有较高的MODS发生率和24 h生存率,是ANP并发MODS诊治研究的理想建模浓度.
목적 탐토우광담산납유도급성배사성이선염(ANP)병발다기관공능쇠갈(MODS)대서모형적량-효관계급이상농도.방법 280지대서안수자수궤법분위대조조(40지)화ANP조,분별채용경이담관역행주사3.5%、4%、4.5%、5%우광담산납제비ANP모형(매농도조60지).술후1、3、6、12、24 h분비처사대서,검측혈청정분매、총담홍소、기항수평,행혈기분석,상규이선병리검사병평분;각ANP조령류20지대서관찰건모후24 h생존솔.결과 각ANP조적혈청정분매、총담홍소、기항수평급양합지수(PaO_2/FiO_2)、이선병리평분균수우광담산납농도증가이승고,정명현적량-효화시-효관계.4.5%우광담산납건모조우술후6 h출현간、신공능장애고봉,12 h출현호흡공능장애고봉,기MODS발생솔위52.5%,현저고우3.5%、4.0%우광담산납건모조적15.0%화37.5%;24 h생존솔위65%,현저고우5%우광담산납건모조적30%.결론 4.5%우광담산납유도ANP대서모형구유교고적MODS발생솔화24 h생존솔,시ANP병발MODS진치연구적이상건모농도.
Objective To explore the dose-effect relationship and optimal concentration of sodium taurocholate (NaTc) to establish acute necrosis pancreatitis (ANP) complicating MODS in a rat. Methods 280 SD rats were randomly divided into control group (n =40) and 3.5%, 4%, 4.5%, 5% ANP group (n = 60, respectively). ANP groups were induced by retrograde injection of NaTc solution into the pancreatic duct of rats. Rats in each model group were sacrificed at 1, 3, 6, 12 and 24 h after the model induction. Serum amylase, serum total bilirubin, creatinine, blood gas analysis, and pathological changes of pancreas were determined. Survival rate at 24 h after the model induction was observed in other 20 ANP rats in each group. Results In each groups, the serum amylase level, creatinine, blood gas analysis and pathological changes all increased corresponding to the increase of NaTc, and there was significant dose-effect relationship and time-effect. In 4.5% group, the dysfunction of liver and kidney reached the peak at 6 h,while the respiratory dysfunction reached its peak at 12 h. Its incidence of MODS was 52.5%, which was significantly higher than those in 3.5%, 4.0% group (15.0% and 37.5%) ;and 24 h survival rate of 4.5% group was 65%, which was significantly higher than that in 5% group (30%). Conclusions 4.5% NaTc solution may be the optimal concentration to establish the ANP model, which had higher incidence of MODS and 24 h survival rate.