【摘要】 目的观察黄芩甙和奥曲肽对重症急性胰腺炎(SAP)大鼠肺损害的影响,探讨两药对SAP的治疗作用与机制。方法采用改良Aho法,经大鼠胰胆管内逆行注射3．5％牛磺胆酸钠制成SAP模型。制模后大鼠随机分为3组：模型组、黄芩甙治疗组、奥曲肽治疗组,另选一组作为假手术组。于术后相应时间点观察各组大鼠的病死率,随后分批处死大鼠,观察肺脏的大体及光镜下病理学变化；观察肺脏的病理学评分变化；应用组织微阵列技术制备肺脏微阵列片,并进行Bax、bcl-2染色,光镜下观察各指标的表达水平变化,同时应用TUNEL技术进行肺脏凋亡细胞的观察及凋亡指数的计算,分析以上各指标间的相关性。结果黄芩甙治疗组、奥曲肽治疗组12h生存率明显大于模型组,差异有显著性(P＜0．05)；各组肺脏病理评分比较显示：不同时间点模型组、黄芩甙治疗组明显大于假手术组(P＜0．01),6h及12h点黄芩甙治疗组明显小于模型组(P＜0．05),奥曲肽治疗组明显小于模型组(P＜0．01)。各组肺脏Bax蛋白表达水平的变化显示：3h点黄芩甙治疗组、奥曲肽治疗组明显大于假手术组和模型组(P＜0．05),同时黄芩甙治疗组明显大于奥曲肽治疗组(P＜0,01)；各组肺脏bcl-2蛋白表达水平的变化显示：模型组和黄芩甙治疗组明显大于假手术组(P＜0．01),并明显大于奥曲肽治疗组(P＜0．05)；6h点黄芩甙治疗组明显小于模型组(P＜0．05),各组肺脏凋亡指数的表达水平变化显示各组无明显差别(P＞0．05)。结论(1)黄芩甙和奥曲肽对SAP肺损害均具有保护作用,其治疗机制可能与细胞凋亡有关。(2)在胰腺炎病理检测中应用组织微阵列技术可以节约成本、提高效率、代表性好,值得推广。更多还原

【Abstract】 Objective To observe the influence of Baicalin and Octreotide on lung injury of rat with severe acute pancreatitis(SAP) and discuss the therapeutic effect and mechanism of the two medicines on SAP.Methods The improved Aho(?)method was adopted to pre- pare SAP rat models via retrograde injection of 3.5% sodium taurocholate to the pancreatic duct.The 135 SAP rat models after being pre- pared were randomly divided into the model group,Baicalin treatment group and Octreotide treatment group with 45 rats in each group;an- other 45 were selected to be the sham operation group which only received abdomen opening surgery.The above - mentioned groups were then randomly divided into 3h,6h and 12h groups with 15 rats in each group.Observed respectively at 3h,6h and 12h after operation,the mortalities of all rat groups followed by batch execution of rats,and then observed the gross pathological and pathological changes of lung. The tissue microarrays technology was applied to prepare the lung tissue microarrays sections.The changes in Bax and bcl-2 protein ex- pression levels of lung tissue of each group were observed via immunohistochemical staining and meanwhile the TUNEL method was applied to observe the lung cell category and apoptotic index changes of lung tissue in each group.Results The 12h survival of model group was 66,67% while those of Baicalin treatment group and Octreotide treatment groups were both 100%,indicating a marked difference(P＜0.05).Comparison of lung pathological score disclosed:The model group and Baicalin treatment group obviously exceeded the sham oper- ation group at various time points(P＜0.01);at 6h and 12h the Baicalin treatment group was obviously less than the model group(P＜0.05)and the Oetreotide treatment group less than the model group(P＜0.01).Comparison of Bax protein of lung in each group dis- closed:The Baicalin treatment group and Octreotide treatment group obviously exceeded the sham operation group and model group at 3h (P＜0.05),meanwhile the Baicalin treatment group obviously exceeded the Octreotide treatment group(P＜0.01).Changes of lung bcl -2 protein expression level of all groups disclosed:The model group and Baicalin treatment group obviously exceeding the sham operation group(P＜0.01)as well as the Octreotide treatment group(P＜0.05)at different time points,the Baicalin treatment group was obviously less than the model group at 6h(P＜0.05).The peak of apoptosis occurred to the Baicalin treatment group at 6h,but statistics showed no obvious difference among all groups at different time points(P＞0.05).Conclusions(1)Both Baicalin and Octreotide have protecting effect on SAP lung injury and their therapeutic mechanism is possibly related to apoptosis.The application of tissue microarrays in SAP pathological examination can save manpower and material resources,cut down the experimental cost and improve the experimental efficien- cy,thus worth popularizing.更多还原