大鼠胰腺炎相关性急性肺损伤模型的探讨

目的研究5%牛磺胆酸钠(TAC)逆行胆胰管注射诱发急性胰腺炎相关肺损伤的大鼠模型。方法采用改进的胆胰管逆行注射TAC造成大鼠急性出血坏死型胰腺炎(AHNP)模型,将大鼠随机分为3组:AHNP组、假手术组、地塞米松(DXM)治疗组。造模成功后,立即静脉注射大剂量DXM(5 mg/kg)。术后于3、6、12 h处死,留取外周血测定血清淀粉酶、脂肪酶,取右肺中叶测定肺湿干比值及作病理切片,计算等级评分评价肺损伤;行支气管肺泡灌洗,以灌洗液白蛋白与血清白蛋白含量比值计算肺指数。结果AHNP组36、、12 h肺通透性指数、湿干比值及病理学评分逐渐增加,经单因素方差分析,61、2 h组高于3 h组(P<0.05),前两者于6、12 h组组内比较差异不显著(P>0.05)。DXM组于术后61、2 h,各项肺损伤指标均低于AHNP组(P<0.05)。结论TAC胆胰管逆行注射造成AHNP模型大鼠于术后6 h即出现明显的肺损伤表现,符合PALI病理改变,与临床AHNP合并急性肺损伤(ALI)的病理过程相似,可于此时相点作为研究AHNP合并肺损伤的模型。

Pancreatitis-Associated Acute Lung Injury in Rats

Objective To creat a pancreatitis-associated acute lung injury(PALI) model in rats by retrograde infusion of 5% sodium tauroculam(TAC) into the biliopancreatic duct.Methods\ A modified procedure of retrograde infusion of TAC into the biliopancreatic duct was used to induce acute hemorrhagic necrotizing pancreatitis(AHNP) in rats.Rats were divided into AHNP,control (laparotomy only,no TAC injection) and dexamethasone(DXM) treatment(after successfully TAC injection,supramaximal dose of DXM was injected) group.The rats were killed at 3,6,12 hours after operation.Serum amylase and lipase were assayed.The middle lobe of right lungs were removed and used for lung edema histopathological evaluation.The ratio of protein content in bronchialo-alveolar lavage fluids (BALFs) to serum proteins was used as lung permeability index.Results\ In the AHNP group,lung permeability index,wet to dry weight ratio and histopathological alterations were increasing with time,higher at 6,12 hours than at 3 hours determined by one way ANOVA analysis(P<0.05).No significant difference was found in the 6,12 hours groups in regard to the former two injury indexes.Compared with AHNP group,injury was less severe in DXM treatment group at 6,12 hours after operation. Conclusions\ Apparent lung injury occurs at 6 hours after pancreatitis induced by retrograde infusion of TAC into the biliopancreatic duct in rats.The pulmonary morphological and functional changes in the model rats are similar to those in AHNP patients with acute lung injury,suggesting its value in PALI studies.