早期大剂量甲强龙冲击治疗对大鼠重症急性胰腺炎的影响

目的 观察早期大剂量甲强龙冲击治疗对大鼠重症急性胰腺炎(SAP)炎症变化以及胰腺组织内T淋巴细胞浸润情况的影响.方法 通过腹腔内注射L-精氨酸(320 mg/100 g)制作大鼠重症胰腺炎模型,96只雄性SD大鼠随机分成正常对照组(NS组,n=32),重症急性胰腺炎组(SAP组,n=32),重症胰腺炎甲基强地松龙治疗组(MES组,n=32),观察SAP模型后6 h、12 h、24 h、72 h胰腺湿干比重、血清淀粉酶以及胰腺CD3~+、CD4~+、CD8~+T淋巴细胞及CD4~+/CD8~+比值变化水平.另外3组各取15只SD大鼠观察72h病死率.结果 SAP组较NS组各时段72 h病死率、血清淀粉酶、胰腺湿干比,而胰腺CD3~+、CD4~+、CD8~+T淋巴细胞百分数及CD4/CD8比值明显降低,MES组较SAP组各时段胰腺湿干比、血清淀粉酶明显降低,CD3~+、CD4~+、CD8~+T淋巴细胞百分数及CD4/CD8比值有所降低,但差异无统计学意义.结论 早期大剂量甲强龙冲击治疗重症急性胰腺炎对降低病死率,改善胰腺炎炎性介质反应具有明显作用,对内毒素水平、胰腺免疫功能影响无统计学意义.

The effect of a large dose of methylprednisolone used early on the development of severe acute pancreatitis in rats

Objective To observe the effect of large dos of methylprednisolone used early on the change of inflammatory reaction and T lymphocyte in pancreas in severe acute pancreatitis(SAP) of rats. Methods SAP was induced by the intraperitoneal administration of L-arginine (320 mg/100 g body weight). Ninty-six male Sprague-Dawley rats were divided randomly into normal group( NS group, n = 32 ), SAP group( n =32), the treatment of methylprednisolone group ( MES group, n = 32). Rats were sacrificed at 6,12, 24 and 72 h after SAP models were developed. Pancreatic weight/body weight ratio, and plasma amylase activity were determined at four time points; CD3~+ , CD4~+, CD8~+ T lymphocytes in pancreas were examined by im-munohistochemistry. Otherwise, the death rate of 15 SD rats was observed during 72 hours in each group. Results SAP group had a significantly higher level of death rate, pancreatic weight/body weight ratio,plasma amylase activity and lower percentage of CD3~+, CD4~+, CD8~+T lymphocyte subsets and CD4~+/CD8~+ratio compared to NS group at every time point;MES group apparently decreased the level of death rate, pancreatic weight/body weight ratio, plasma amylase activity compared to SAP group;MES group had lower percentage of CD3~+, CD4~+, CD8~+T lymphocyte subsets and CD4~+/CD8~+ratio at some time points,but had no statistic significance compared to SAP group. Conclusions A large dose of methylprednisolone has a apparent effect on decreasing death rote,suppressing inflammatory reaction early,but to the level of T lymphocyte in pancreas it was of non-statistical significance.