Effect On Intra-abdominal Pressure By Xuebijing Injection In Severe Acute Pancreatitis Rats

?Background?Severe acute pancreatitis(SAP),which is a clinically common and critical illness,can cause a lot of complications such as intra-abdominal hypertension(IAH),intestinal mucosal barrier dysfunctional(IMBD),acute respiratory distress syndrome(ARDS),acute kidney injury(AKI),septic shock and et al.The incidence rate of SAP is 10-20% of acute pancreatitis(AP),and the mortality rate of SAP is close to 30%.SAP poses a huge threat to people's health.Intra-abdominal hypertension(IAH)is one of the common complications of SAP.If the intra-abdominal pressure(IAP)continues to rise and cannot be effectively controlled,it can lead to organ function damage and eventually multiple organ dysfunction syndrome(MODS).IAH often involves the intestines.The intestinal function damage caused by IAH is one of the reasons for inducing intestine-derived endotoxemia and even systemic infection,causing the condition to deteriorate further.So far,the pathogenesis of IAH caused by SAP has not been fully clarified,and current research believes that it is closely related to systemic inflammatory response syndrome(SIRS),which needs further confirmation.Xuebijing injection is an intravenous preparation made by Professor Wang jinda.Through the analysis of its chemical composition,the researchers found that it contains a variety of effective chemical ingredients with antibacterial and anti-inflammatory properties.In 2004,Xuebijing injection was approved for marketing and used for clinical treatment of diseases such as SIRS,MODS and sepsis.So far,a lot of clinical studies have suggested that Xuebijing injection can delay the progression of SAP patients and reduce complications,but the mechanism of its specific efficacy has not been clarified.?Objective?In this study,SAP rats were used as the research object to observe the effects of early applying Xuebijing injection on pathological changes of pancreatic tissue and small intestinal mucosa,the plasma levels of inflammatory cytokines,intestinal mucosal barrier function and IAP in SAP rats,and to explore the effect and mechanism of early applying Xuebijing injection on IAP of SAP rats.?Methods?(1)We selected 15 SD rats and randomly divided them into 3 groups: control group(n = 5),SAP group(n = 5)and treatment group(n = 5).(2)The rats in the SAP group and the treatment group were retrogradely injected with 4.5% sodium taurocholate solution through the biliopancreatic duct to prepare the SAP model,while the control group rats were only retrogradely injected with 0.9% sodium chloride solution through the biliopancreatic duct.The rats in the treatment group were injected intraperitoneally with Xuebijing injection immediately after modeling.(3)After 24 hours of successful modeling,the general condition of the rats in each group was evaluated,and the intra-abdominal pressure and ascites volume of rats in each group were measured.The blood of the rats was collected through the celiac artery to retain blood samples for examination.After the rats were sacrificed,the pancreatic tissue and small intestinal tissue were separated for examination.(4)the pancreatic tissue and the small intestinal tissue were embedded,sectioned,HE stained and their pathological score were evaluated under light microscope.the plasma amylase(AMS)was detected by using a fully automatic biochemical analyzer.The plasma levels of tumor necrosis factor-?(TNF-?),interleukin-1?(IL-1?),interleukin-6(IL-6),endotoxin(ET)and diamine oxidase(DAO)were detected by using enzyme-linked immunosorbent assay(ELISA).(5)The differences of the general condition,IAP,ascites volume,pathological score of pancreatic tissue,pathological score of small intestinal mucosa,and the plasma levels of AMS,TNF-?,IL-1?,IL-6,ET and DAO of the rats in three groups were compared.?Results?(1)Compared with the control group,the pathological score of the pancreatic tissue and the plasma level of AMS in the SAP group were significantly increased(p <0.05),indicating that the SAP model used in this study was successfully modeled.Compared with the SAP group,the pathological score of the pancreatic tissue and the plasma level of AMS in the treatment group were decreased significantly(p <0.05),suggesting that early applying Xuebijing injection can effectively reduce the pancreatic tissue damage of the SAP rats.(2)Compared with the control group,the rats' IAP and ascites in the SAP group were significantly increased(p <0.05),while the rats' IAP and ascites in the treatment group were not significantly different(p > 0.05),suggesting that peritoneal effusion and IAH may occur in SAP rats early.Compared with the SAP group,the rats' IAP and ascites in the treatment group decreased significantly(p <0.05),indicating that early applying Xuebijing injection can effectively reduce the IAP of the SAP rats and reduce the formation of ascites.(3)Compared with the control group,the pathological score of the small intestinal mucosa and the plasma levels of ET and DAO in the SAP group were significantly increased(p <0.05),while the pathological score of the small intestinal tissue and the plasma level of DAO in the treatment group were also significantly increased(p <0.05),indicating that SAP rats have already suffered intestinal mucosa injury in the early stage of onset.Compared with the SAP group,the pathological score of the small intestinal mucosa and the plasma levels of ET and DAO in the treatment group were significantly decreased(p <0.05),suggesting that early applying Xuebijing injection can effectively reduce the small intestinal mucosa damage of the SAP rats.(4)Compared with the control group,the plasma levels of IL-1? and IL-6 in the SAP group were significantly increased(p <0.05),while the plasma levels of TNF-? and IL-6 in the treatment group were also significantly increased(p <0.05),suggesting that the plasma levels of inflammatory cytokines in SAP rats has increased significantly in the early stage of onset.Compared with the SAP group,the plasma levels of TNF-?,IL-1? and IL-6 in the treatment group decreased significantly(p <0.05),suggesting that early applying Xuebijing injection can effectively reduce the plasma levels of inflammatory cytokines in SAP rats.?Conclusions?(1)Early applying Xuebijing injection can reduce the IAP of the SAP rats and reduce the formation of ascites,which can contribute to delay the occurrence of IAH.(2)Early applying Xuebijing injection can reduce the plasma levels of TNF-?,IL-1?,IL-6,ET and DAO of the SAP rats,suggesting that it can reduce SIRS and delay the occurrence of intestinal mucosal barrier function damage,which has a protective effect on intestinal function.