奥曲肽治疗急性坏死性胰腺炎作用机制的实验研究医学.doc

奥曲肽治疗急性坏死性胰腺炎作用机制的实验研究 余枭　张圣道　雷若庆　夏宗勤　韩天权　汤耀卿　陈胜　王建承　袁祖荣 　　【摘要】　目的　探讨奥曲肽治疗急性坏死性胰腺炎(ANP)的作用机制。方法　作者采用核素示踪和放射自显影技术，研究了奥曲肽对正常大鼠和大鼠ANP时胰腺腺泡细胞氨基酸摄取、酶蛋白合成及分泌功能的影响。结果　奥曲肽对正常胰腺腺泡细胞和呈点状出血坏死的ANP胰腺腺泡细胞氨基酸摄取、酶蛋白合成均无明显影响，但可明显抑制胰腺腺泡细胞的外分泌功能，导致细胞内酶原颗粒积聚，ANP时胰腺腺泡细胞出现底膜及侧膜的异位分泌，奥曲肽能够减少腺泡细胞的这种异位分泌。结论　奥曲肽对胰腺腺泡细胞氨基酸摄取、酶蛋白合成无影响，但可抑制胰腺腺泡细胞的外分泌，尤其对ANP时腺泡细胞的异位分泌具有抑制作用，防止了酶原颗粒在细胞间质的积聚。　　【关键词】　奥曲肽；急性坏死性胰腺炎；细胞功能；核素示踪；放射自显影 Experimental study of the therapeutic mechanism of Octreotide in acute necrotizing pancreatitis (ANP) YU Xiao，ZHANG Shengdao，LEI Ruoqing，et al.（Department of Surgery，Hengyang Central Hospital，Hengyang，421001，China） 　　【Abstract】　Objective　To study the therapeutic mechanism of Octreotide in acute necrotizing pancreatitis (ANP). Methods　The authors observed the effects of Octreotide on the pancreatic acinar cells with respect to amino acid uptake，protein synthesis and discharge of protein by the techniques of radioactive tracer and autoradiography in ANP and control rats. Results　It showed that Octreotide had no effects on pancreatic acinar cells in amino acid uptake and protein syhthesis both in ANP and control rats，but it could inhibit the secretion of enzymatic protein. There was ectopic secretion from the basal and lateral membranes of the acinar cells in ANP，and Octreotide could decrease the ectopic secretion. Conclusion　Octreotide has no effects on pancreatic acinar cells in amino acid uptake and enzyme protein synthesis，but it inhibits the secretion of enzyme protein，especially the ectopic secretion of acinar cells in ANP and thus prevents the accumulation of zymogen granules in the interstitium.　　【Key words】　Octreotide; Acute necrotizing pancreatitis; Cellular function; Radioactive tracer; Auto-radiography 　　自从人工合成八肽生长抑素拟似剂——奥曲肽(Octreotide)以来，目前已广泛应用于临床治疗急性坏死性胰腺炎(acute necrotizing pancreatitis，ANP)［1］、胰瘘［2］等疾病。初步临床观察具有明显疗效，但其作用机制尚未完全得到阐明。为此，作者通过动物实验研究了奥曲肽对胰腺腺泡细胞氨基酸摄取、酶蛋白合成及分泌功能的影响。 材料与方法 　　一、实验材料　　1. 实验动物：SD雄性大鼠140只，体重160～180g，常规喂养，实验前12h禁食，自由饮水。　　2. 实验材料：牛磺胆酸钠(S