摘要
目的探讨高压氧(HBO)及乌司他丁(ULT)单独或联合应用治疗急性坏死性胰腺炎(ANP)的疗效及其作用机理。方法将健康SD大鼠120只按随机数字表法随机均分为6组:正常对照组、假手术组、急性坏死性胰腺炎组(ANP组)、ANP高压氧治疗组(HBO组)、ANP乌司他丁治疗组(ULT组)、ANP高压氧和乌司他丁联合治疗组(HBO+ULT组),分别采用HBO、ULT单独或者联合治疗ANP动物模型,观察细胞因子和血清淀粉酶(AMS)水平的变化以及胰腺病理组织学改变。结果ANP动物模型建立后2、6及8h,除6-酮-前列腺素F1α(6-keto-PGF1α)外,HBO组、ULT组及HBO+ULT组血清AMS、肿瘤坏死因子α(TNFα)及血栓素B2(TXB2)明显低于ANP组(P<0.01);HBO组血清AMS及TNFα均高于HBO+ULT组(P<0.01);ULT组与HBO+ULT组比较,只有AMS的差异有统计学意义(P<0.01)。ANP组胰腺病理组织学评分及CD8计数明显比HBO组、ULT组及HBO+ULT组高(P<0.05),而CD4计数、CD4/CD8比值均比其它处理组低(P<0.05)。HBO组、ULT组胰腺病理组织学评分明显比HBO+ULT组高(P<0.05)。结论①高压氧和乌司他丁都能有效地抑制血清胰酶及细胞因子的分泌与释放,改善胰腺局部免疫功能;②高压氧和乌司他丁联合治疗能取得比单用其中一种方法更好的疗效。
Objective To investigate therapeutic effect and mechanism of hyperbaric oxygen and ulinastatin respectively or combinatively used to treat acute necrotizing pancreatitis （ANP）. Methods One hundred and twenty SD rats were divided into 6 groups randomly： group of normal control, group receiving sham operation, group of untreated acute necrotizing pancreatitis （ANP group）, group of acute necrotizing pancreatitis treated with hyperbaric oxygen （HBO group）, group of acute necrotizing pancreatitis treated with ulinastatin （ULT group）, and group of acute necrotizing pancreatitis treated with combined hyperbaric oxygen and ulinastatin （HBO＋ULT group）. The rat model of acute necrotizing pancreatitis was established according to Aho HJ et al. Concentrations of amylase, TNFα, TXB2 and 6-keto-PGF1a in blood were measured through ELISA or radioimmunoassay. Changes of pancreatic histopathology were investigated. SPSS 10.0 was used in statistical analysis. Results The concentrations of amylase, TNFα, TXB2 in the ANP-treated groups were significantly lower than those of ANP group （P〈0. 01） except for 6-keto-PGF1a and the levels of amylase and TNFα of HBO group were strikingly higher than those in HBO＋ ULT group. Only the level of AMS was significantly different 0.01）. Pancreas histopathological scores（HS） and CD8 counts between ULT group and HBO＋ULT group （P〈 of ANP group were significantly higher than those the other three group, but CD4 counts and CD4/CD8 ratio were on the contrary （P〈0.05）, HS of HBO and ULT were strikingly higher than those of HBO＋ULT （P〈0.05）. Conclusion ①Hyperbaric oxygen or ulinastatin can effectively decrease the blood levels of enzymes and cytokines and improve the pancreatic immunity. ②Hyperbarie oxygen in combination with ulinastatin are more effective than either of them in the treatment of ANP.
出处
《中国普外基础与临床杂志》
CAS
2005年第5期438-442,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
急性坏死性胰腺炎
高压氧
乌司他丁
联合治疗
Acute necrotizing pancreatitis Hyperbaric oxygen Ulinastatin Combinative treatment
