| Objective: Severe acute pancreatitis (SAP) is a fatal surgical disease,often be in companion with multiple system organ failure and high morality with lung,heart and adrenal complication.Experiment studies have demonstrated that the imbalance of inflammatory factors and anti-inflammatory factors plays the important role during acute severe pancreatitis in recent years.People began to realize that the disorder of CK eruption resulted in progress of diseases.The most important cause of early death in SAP is lung injury with ARDS.The most important measure to decrease early morality in SAP is the treatment of lung injury.The reports that experimental SAP animals with lung injury were treated by rhubarb are a few. The report that experimental SAP animals with lung injury were treated by ulinastatin or rhubarb and ulinastatin is few.The aim of this study is to investigate the serum lever of AMY, LIP, IL-6, TNF-a,MDA,SOD in the red cells and PO2,PCO2 in arterial blood,to observe the pathologic changes for pancreas,lungs in SAP rat model,and to study the influence of rhubarb, ulinastatin.This research was done to elucidate the reasonablemechanics of SAP with lung injury and influence of ulinastatin,rhubarb.Methods: SAP model was induced by contra-injection of 5% sodium taurocholate to pancreatic duct. 160 health S-D rats randomly divided into 20 groups:fame AP 2h,6h, 12h,24h groups;SAP2h,SAP6h,SAP12h,SAP24h groups (fame treated groups); ulinastatin treated groups,rhubarb treated groups and ulinastatin+rhubarb treated groups. Determining serum level of AMY, LIP, TNF-a, IL-6, MDA, SOD in red-celland PO2,PCO2 in arterial blood,pancreatic pathologic grades.Weigh pancreas,lungs,count their quotiety and observe their changes after therapy.Results:After operation, serum level of AMY,LIP, the amount of the ascites and pathology scores of pancreas in SAP rat model kept rising continuously.Difference is significantly,the more longer the time,the more serious the case.Pancreas were observed edema,hemorrhage,necrosis spots; Lungs were observed edema, hemorrhage, imflammatory cell infiltration under light microscope and pulmonary atelectasis.The more longer the time,the more serious the damage.(2)The serum level of TNF, IL-6,MDA, increased significantly in SAP groups.(3) SOD in red-cell decreased significantly in SAP groups. (4) PO2 in arterial blood decreased significantly and PCO2 in arterial blood increased significantly in SAP groups(except SAP2h).(5) After cervcial vein injection of ulinastatin,stoma-duct ofjejunum injection of rhubarb,the pathology changes of pancreas and lungs get better,AMY,LIP,TNF- a ,IL-6 and MDA,PCO2 in arterial blood,the amount of the ascites decrease significantly,SOD,PO2 in arterial blood (except SAP2h) increased significantly.When compared to single drug treated groups,partly changes were significan.Conclusions: The method to conrra-injection 5% sodium taurocholate to pancreatic duct to induce SAP with lung injury.Pancreas were observed edema,hemorrhage, necrosis spots;Lungs were observed edema, hemorrhage, imflammatory cell infiltration under light microscope and pulmonary atelectasis.The model is duplicated,valuable, easily. (2) TNF-a,IL-6,MDA shows important roles in pathogence of SAP,and are reasonable injury effects,SOD is a protective factor.They can be considered as important marker to serious degree of SAP with lung injury.There are clearly marker and the pathology changes of lungs in SAP rat model. The change of PO2 and PCO2 in arterial blood is that TNF-ct and IL-6 were activated and super-released.TNF-a and IL-6 damage the pulmonary endothelial cell and cause pulmonary edema,imflammatory cell infiltration.They can be considered as important marker to serious degree of SAP with lung injury. (4)The early application of ulinastatin,rhubarb have definite therapy action to SAP with lung injury by decreasing the damage-factors and increasing the protection-factors.The effect is better by applying ulinastatin and rhubarb. |
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