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目的探讨高压氧(HBO)与乌司他丁联合治疗大鼠急性坏死性胰腺炎对(ANP)血内毒素,sCD14,血浆灭活内毒素能力(EIC)及其预后的影响。方法将SD大鼠随机分为正常对照组(A组),假手术组(B组),ANP组(C组),ANP+HBO组(D组),ANP+乌司他丁组(E组),ANP+HBO+乌司他丁组(F组)。模型建立5 min后,E组和F组门静脉注射乌司他丁(20 000 U/kg);30 min后,D组和F组给予HBO治疗2 h。3,6,10 h后各组分别测定血清内毒素,sCD14,EIC,肿瘤坏死因子α(TNF-α),观察各组大鼠的生存时间。结果 (1)D,E组内毒素和sCD14水平在建模后3,6 h均明显低于C组(P<0.05),F组内毒素和sCD14水平在建模后3,6,10 h明显低于C,D,E组(P<0.05)。(2)建模3,6,10 h,D,E,F组的EIC水平明显高于C组(P<0.05),F组的EIC水平均明显高于D,E组(P<0.05)。(3)建模3,6,10 h,D,E,F组的TNF-α水平明显低于C组(P<0.05),F组的TNF-α水平明显低于D,E组(P<0.05)。(4)D,E,F组的生存时间明显超过C组(P<0.05),F组的生存时间明显超过D,E组(P<0.05)。结论单独应用高压氧和乌司他丁治疗ANP,均能取得明显疗效,但高压氧和乌司他丁联合治疗的效果优于单一种方法的效果。
Objective To investigate the effects of hyperbaric oxygen (HBO) combined with ulinastatin on endothelin (sIC14), endotoxin in plasma (EIC) and its prognosis in rats with acute necrotizing pancreatitis (ANP). Methods SD rats were randomly divided into normal control group (A group), sham operation group (B group), ANP group (C group), ANP + HBO group (D group), ANP + ulinastatin group , ANP + HBO + ulinastatin group (group F). After 5 min of establishment of the model, ulinastatin (20 000 U / kg) was injected into the portal vein of group E and group F. After 30 min, group D and F were given HBO for 2 h. Serum endotoxin, sCD14, EIC and tumor necrosis factor α (TNF-α) were measured at 3, 6 and 10 h after operation. The survival time of each group was observed. Results (1) The levels of endotoxin and sCD14 in groups D and E were significantly lower than those in group C at 3 and 6 h after modeling (P <0.05). The levels of endotoxin and sCD14 in group F at 3, 6 and 10 h after modeling Significantly lower than C, D, E group (P <0.05). (2) The EIC levels in D, E and F groups were significantly higher than those in C group (P <0.05) at 3, 6 and 10 h after modeling. The EIC levels in F group were significantly higher than those in D and E groups (P <0.05) . (3) The levels of TNF-α in D, E and F groups were significantly lower than those in C group (P <0.05) at 3, 6 and 10 h after modeling. The levels of TNF- <0.05). (4) The survival time of group D, E and F obviously exceeded that of group C (P <0.05), and the survival time of group F obviously exceeded that of group D and E (P <0.05). Conclusion Both hyperbaric oxygen and ulinastatin alone can be used to treat ANP. However, the combination of hyperbaric oxygen and ulinastatin is more effective than the single method.