中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2014年
3期
158-162
,共5页
刘伟峰%孙君军%郑刚%常永超%戚世芳%张玉明%褚智杰%杨延辉
劉偉峰%孫君軍%鄭剛%常永超%慼世芳%張玉明%褚智傑%楊延輝
류위봉%손군군%정강%상영초%척세방%장옥명%저지걸%양연휘
胰腺炎,急性坏死性%肺损伤%血栓素A2%前列环素
胰腺炎,急性壞死性%肺損傷%血栓素A2%前列環素
이선염,급성배사성%폐손상%혈전소A2%전렬배소
Pancreatitis,acute necrotizing%Lung injury%Thromboxane A2%Prostacyclin
目的 观察特异性血栓素合成酶抑制剂对急性坏死性胰腺炎(ANP)犬胰腺及肺损伤的影响,探讨其作用机制.方法 20只健康雄性杂种犬按数字表法随机分为对照组(4只)、ANP组(8只)及特异性血栓素合成酶抑制剂(商品名:丹奥)治疗组(治疗组,8只).采用胰管内逆行注射5％牛黄胆酸钠及胰蛋白酶混合液的方法制备ANP模型,治疗组于制模成功后2h起静脉输注2 mg/kg体质量的丹奥,每天2次,连用7d.术后动态监测各组血清钙、超敏C反应蛋白(HCRP)、血栓素A2(TXA2)、前列环素(PGI2)水平.7d后处死动物,取胰腺及肺组织行病理学检查,并评分.结果 对照组胰腺及肺组织无明显病理改变;ANP组胰腺及肺损伤严重;治疗组胰腺及肺组织损伤较ANP组减轻.对照组、ANP组、治疗组的胰腺病理评分分别为(1.25±0.96)、(7.00±2.39)、(4.63±1.19)分;肺组织病理评分分别为(0.75±0.50)、(7.13±1.55)、(4.88±0.83)分,ANP组、治疗组的胰腺、肺组织病理评分均显著高于对照组,而治疗组的评分又较ANP组显著降低(P值均＜0.05).对照组术后1d的血清钙、HCRP、TXB2、keto-PGFla水平及TXB2/keto-PGFla比值分别为(2.45±0.07) mmol/L、(30.36 ±4.29)mg/L、(345.8±46.8) pg/ml、(187.8±18.6) pg/ml、1.85±0.16; ANP组为(2.21±0.08) mmol/L、(72.04±10.22)mg/L、(1227.3±118.2) pg/ml、(368.8±64.4) pg/ml、3.33±0.19;治疗组为(2.32±0.08) mmol/L、(66.51 ±4.28) mg/L、(1179.5±116.3)pg/ml、(371.8±65.2) pg/ml、3.17±0.18. ANP组与治疗组术后血清钙水平较对照组显著下降,而其他指标显著升高,差异均具有统计学意义(P值均＜0.01).治疗组血清钙水平显著高于ANP组,血HCRP水平显著低于ANP组,差异有统计学意义(P ＜0.05或＜0.01).结论 应用特异性血栓素合成酶抑制剂治疗后ANP犬的胰腺及肺脏损伤程度减轻,其机制与阻断TXA2合成,纠正TXA2/PGI2的比例失衡,改善胰腺及肺组织微循环有关.
目的 觀察特異性血栓素閤成酶抑製劑對急性壞死性胰腺炎(ANP)犬胰腺及肺損傷的影響,探討其作用機製.方法 20隻健康雄性雜種犬按數字錶法隨機分為對照組(4隻)、ANP組(8隻)及特異性血栓素閤成酶抑製劑(商品名:丹奧)治療組(治療組,8隻).採用胰管內逆行註射5％牛黃膽痠鈉及胰蛋白酶混閤液的方法製備ANP模型,治療組于製模成功後2h起靜脈輸註2 mg/kg體質量的丹奧,每天2次,連用7d.術後動態鑑測各組血清鈣、超敏C反應蛋白(HCRP)、血栓素A2(TXA2)、前列環素(PGI2)水平.7d後處死動物,取胰腺及肺組織行病理學檢查,併評分.結果 對照組胰腺及肺組織無明顯病理改變;ANP組胰腺及肺損傷嚴重;治療組胰腺及肺組織損傷較ANP組減輕.對照組、ANP組、治療組的胰腺病理評分分彆為(1.25±0.96)、(7.00±2.39)、(4.63±1.19)分;肺組織病理評分分彆為(0.75±0.50)、(7.13±1.55)、(4.88±0.83)分,ANP組、治療組的胰腺、肺組織病理評分均顯著高于對照組,而治療組的評分又較ANP組顯著降低(P值均＜0.05).對照組術後1d的血清鈣、HCRP、TXB2、keto-PGFla水平及TXB2/keto-PGFla比值分彆為(2.45±0.07) mmol/L、(30.36 ±4.29)mg/L、(345.8±46.8) pg/ml、(187.8±18.6) pg/ml、1.85±0.16; ANP組為(2.21±0.08) mmol/L、(72.04±10.22)mg/L、(1227.3±118.2) pg/ml、(368.8±64.4) pg/ml、3.33±0.19;治療組為(2.32±0.08) mmol/L、(66.51 ±4.28) mg/L、(1179.5±116.3)pg/ml、(371.8±65.2) pg/ml、3.17±0.18. ANP組與治療組術後血清鈣水平較對照組顯著下降,而其他指標顯著升高,差異均具有統計學意義(P值均＜0.01).治療組血清鈣水平顯著高于ANP組,血HCRP水平顯著低于ANP組,差異有統計學意義(P ＜0.05或＜0.01).結論 應用特異性血栓素閤成酶抑製劑治療後ANP犬的胰腺及肺髒損傷程度減輕,其機製與阻斷TXA2閤成,糾正TXA2/PGI2的比例失衡,改善胰腺及肺組織微循環有關.
목적 관찰특이성혈전소합성매억제제대급성배사성이선염(ANP)견이선급폐손상적영향,탐토기작용궤제.방법 20지건강웅성잡충견안수자표법수궤분위대조조(4지)、ANP조(8지)급특이성혈전소합성매억제제(상품명:단오)치료조(치료조,8지).채용이관내역행주사5％우황담산납급이단백매혼합액적방법제비ANP모형,치료조우제모성공후2h기정맥수주2 mg/kg체질량적단오,매천2차,련용7d.술후동태감측각조혈청개、초민C반응단백(HCRP)、혈전소A2(TXA2)、전렬배소(PGI2)수평.7d후처사동물,취이선급폐조직행병이학검사,병평분.결과 대조조이선급폐조직무명현병리개변;ANP조이선급폐손상엄중;치료조이선급폐조직손상교ANP조감경.대조조、ANP조、치료조적이선병리평분분별위(1.25±0.96)、(7.00±2.39)、(4.63±1.19)분;폐조직병리평분분별위(0.75±0.50)、(7.13±1.55)、(4.88±0.83)분,ANP조、치료조적이선、폐조직병리평분균현저고우대조조,이치료조적평분우교ANP조현저강저(P치균＜0.05).대조조술후1d적혈청개、HCRP、TXB2、keto-PGFla수평급TXB2/keto-PGFla비치분별위(2.45±0.07) mmol/L、(30.36 ±4.29)mg/L、(345.8±46.8) pg/ml、(187.8±18.6) pg/ml、1.85±0.16; ANP조위(2.21±0.08) mmol/L、(72.04±10.22)mg/L、(1227.3±118.2) pg/ml、(368.8±64.4) pg/ml、3.33±0.19;치료조위(2.32±0.08) mmol/L、(66.51 ±4.28) mg/L、(1179.5±116.3)pg/ml、(371.8±65.2) pg/ml、3.17±0.18. ANP조여치료조술후혈청개수평교대조조현저하강,이기타지표현저승고,차이균구유통계학의의(P치균＜0.01).치료조혈청개수평현저고우ANP조,혈HCRP수평현저저우ANP조,차이유통계학의의(P ＜0.05혹＜0.01).결론 응용특이성혈전소합성매억제제치료후ANP견적이선급폐장손상정도감경,기궤제여조단TXA2합성,규정TXA2/PGI2적비례실형,개선이선급폐조직미순배유관.
Objective To study the role of specific thromboxane synthase inhibitor in dogs with acute necrotizing pancreatitis (ANP) associated lung injury and investigate the possible mechanism.Methods Twenty healthy male mongrel dogs were randomly divided into simple operation group (control group,n =4),ANP model group (ANP group,n =8) and ANP model with specific thromboxane synthase inhibitor (Ozagrel) treatment group (treatment group,n =8).The ANP model was induced by retrograde injection with 5％sodium taurocholate and trypsin into the pancreatic duct.The treatment group was given intravenous infusion of Ozagrel (2 mg/kg,twice a day for 7 days) 2 h after the induction of ANP model.The serum calcium,hypersensitive C-reactive protein (HCRP),thromboxane A2(TXA2),prostacyclin (PGI2) levels were monitored dynamically.Seven days later,the dogs were sacrificed,pancreas and lung tissues were harvested for pathological examinations and scored.Results No obvious pathological changes were seen in pancreas and lung tissues in control group,but significant pathological changes were observed in ANP group,and the pathological changes in treatment group were attenuated.The pathological scores of pancreas in control group,ANP group and treatment group were (1.25 ± 0.96),(7.00 ± 2.39),(4.63 ± 1.19),and the pathological scores of lung were (0.75 ± 0.50),(7.13 ± 1.55),(4.88 ± 0.83),and the values in ANP group and treatment group were significantly higher than that in control group,in addition,the value in treatment group was significantly lower than that in ANP group (P ＜ 0.05).The serum levels of calcium,HCRP,TXB2,keto PGFla and TXB2/keto PGFla ratio were (2.45 ± 0.07) mmol/L,(30.36 ± 4.29) mg/L,(345.8 ± 46.8) pg/ml,(187.8 ± 18.6)pg/ml,1.85 ± 0.16 in control group 1 d later; the corresponding values in ANP group were (2.21 ± 0.08) mmol/L,(72.04 ± 10.22) mg/L,(1227.3 ± 118.2) pg/ml,(368.8 ± 64.4) pg/ml,3.33 ± 0.19; and the corresponding values in treatment group were (2.32 ± 0.08) mmol/L,(66.51 ± 4.28)mg/L,(1179.5 ± 116.3) pg/ml,(371.8 ± 65.2) pg/ml,3.17 ± 0.18.The serum levels of calcium in ANP group and treatment group were significantly lower than that in control group,but other parameters were significantly increased,and the difference among the 3 groups was statistically significant (P ＜ 0.01).The serum level of calcium in treatment group was significantly higher than that in ANP group,while the serum level of HCRP was significantly lower than that in ANP group,and the difference between the two groups was statistically significant (P ＜ 0.01).Conclusions The pancreas and lung injury in dogs with acute necrotizing pancreatitis is attenuated with specific thromboxane synthase inhibitor treatment,and its mechanism may be blockade of TXA2 synthesis,correction of TXA2/PGI2 imbalance and improved pancreas and lung microcirculation.
