CAJ | 학술논문

目的观察生长抑素(SS)和生长激素(GH)联合应用对重症急性胰腺炎(SAP)兔肠黏膜屏障损伤的保护作用,探讨其对治疗SAP的意义.方法 72只新西兰大白兔平均分为3组,SAP模型组(SAP组)、SS治疗组(SS组)以及SS和GH联合治疗组(SS+GH组).经胰管开口逆行注入5%牛磺胆酸钠溶液诱导兔SAP模型,造模后3组均每日予5%葡萄糖氯化钠(GNS)治疗,SS组造模后按3.5μg·kg-1·h-1持续48 h泵入SS治疗,SS+GH组造模后第1、24 h在持续泵入SS的基础上,按0.15 IU/kg皮下注射GH治疗.观察各组动物造模后第6、12、24、48小时血清淀粉酶、肿瘤坏死因子(TNF)-α,血浆二胺氧化酶水平的变化,观察兔胰腺和肠黏膜的病理学变化及存活率.采用SPSS 16.0统计软件进行分析,组间比较采用单因素方差分析.结果 SS+GH组兔血清TNF-α和血浆二胺氧化酶水平较SAP组和SS组均明显降低,造模后24 h[分别为(2.43±0.14)pg/ml和(4.61±0.45)U/L]和48 h[分别为(2.08±0.23)pg/rl和(3.75±0.47)U/L]较SS组[24 h分别为(2.80±0.30)pg/ml和(8.74±1.77)U/L,48 h分别为(2.45±0.12)pg/m1和(5.02±0.95)U/L]显著降低,差异均有统计学意义(P＜0.05).SS+GH组较SAP组和SS组兔肠黏膜炎性反应减轻,肠黏膜的完整性增加,胰腺组织炎性反应减轻,存活率提高,但血清淀粉酶在各时间点与SS组相比差异均无统计学意义.结论 SS和GH联合应用可增强兔肠黏膜屏障功能,改善SAP预后.
목적 관찰생장억소(SS)화생장격소(GH)연합응용대중증급성이선염(SAP)토장점막병장손상적보호작용,탐토기대치료SAP적의의.방법 72지신서란대백토평균분위3조,SAP모형조(SAP조)、SS치료조(SS조)이급SS화GH연합치료조(SS+GH조).경이관개구역행주입5%우광담산납용액유도토SAP모형,조모후3조균매일여5%포도당록화납(GNS)치료,SS조조모후안3.5μg·kg-1·h-1지속48 h빙입SS치료,SS+GH조조모후제1、24 h재지속빙입SS적기출상,안0.15 IU/kg피하주사GH치료.관찰각조동물조모후제6、12、24、48소시혈청정분매、종류배사인자(TNF)-α,혈장이알양화매수평적변화,관찰토이선화장점막적병이학변화급존활솔.채용SPSS 16.0통계연건진행분석,조간비교채용단인소방차분석.결과 SS+GH조토혈청TNF-α화혈장이알양화매수평교SAP조화SS조균명현강저,조모후24 h[분별위(2.43±0.14)pg/ml화(4.61±0.45)U/L]화48 h[분별위(2.08±0.23)pg/rl화(3.75±0.47)U/L]교SS조[24 h분별위(2.80±0.30)pg/ml화(8.74±1.77)U/L,48 h분별위(2.45±0.12)pg/m1화(5.02±0.95)U/L]현저강저,차이균유통계학의의(P＜0.05).SS+GH조교SAP조화SS조토장점막염성반응감경,장점막적완정성증가,이선조직염성반응감경,존활솔제고,단혈청정분매재각시간점여SS조상비차이균무통계학의의.결론 SS화GH연합응용가증강토장점막병장공능,개선SAP예후.
Objective To investigate the protective effect of somatostatin (SS)combined with growth hormone (GH) in treatment of intestinal mucosal barrier injury in rabbits with severe acute pancreatitis (SAP), as well as its clinical significance. Methods Seventy-two rabbits were equally assigned into model group (SAP group), SS treated group (SS group) and SS combined with GH treated group (SS + GH group). SAP models were induced by retro-injection of 5% sodium taurocholate into the pancreatic duct. After modeling, all rabbits were given 5 % glucose saline daily.The rabbits in SS group and SS+GH group were continuously Given SS (3.5μg·kg-1·h-1)for 48 hours. Besides, the rabbits in SS+GH group were subcutaneously injected with 0.15 IU/kg of GH at the 1st and the 24th hours after modeling. The levels of serum amylase, serum tumor necrosis factor-α (TNF-α) and plasma diamine oxidase were measured at the 6th, 12th, 24th and 48th hours after modeling. The pathological changes of pancreatic tissue and ileal mucosa were observed. Survival rate was calculated. Data were analyzed using SPSS 16.0 software. The univariate analysis was used to compare the difference among groups. Results In SS+GH group, the levels of serum TNF-α and plasma diamine oxidase were (2. 43 ± 0. 14) pg/ml and (4. 61 ± 0. 45) U/L at the 24th hour respectively, and were (2.08±0.23) pg/ml and (3.75±0.47) U/L at the 48th hour, respectively,which were lower than those in SAP group and SS group [(2.80 0.30) pg/ml and (8.74 ± 1.77)U/L, respectively, at the 24th hour; (2. 45±0.12) pg/ml and (5. 02±0.95) U/L, respectively, at the 48th hour)]with significant difference (P＜0.05). The inflammation in pancreas and ileal mucosa was alleviated, and the integrity of bowel mucosa was improved. Survival rate of SS+GH group was significantly higher than SAP group and SS group. There was no significant difference in level of serum amylase between SS+GH group and SS group. Conclusion The combination of SS with GH may enhance the function of intestinal mucosa barrier and improve the prognosis of SAP in rabbits.