关键词: 胰腺炎, 急性坏死性, 自噬, 炎症, NF-κB, 重症急性胰腺炎, 雪莲注射液

Abstract: Objective　To explore the therapeutic effect of Saussurea involucrata injection on severe acute pancreatitis (SAP). Methods　Fifty SAP patients were randomly divided into the routine treatment group (treated with routine method) and the Saussurea involucrata injection group (treated with routine method plus i.m. 0.5% Saussurea involucrata injection) by using random number table method, 25 patients in each group. At the same time, 25 healthy physical examinees were used as normal control group (treated with nothing). At 1 d before treatment and 10 d after treatment, the serum levels of Beclin-1 and microtubule-associated protein-1 light chain-3 (LC3) were measured by double antibodies sandwich enzyme-linked immunosorbent assay (ELISA), and the serum levels of nuclear factor kappa B (NF-κB) p65, tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 were measured by ELISA. The acute physiology and chronic health evaluation (APACHE) Ⅱand pancreas modified CT severity index (MCTSI) scores were evaluated, and patient hospital stay and abdominal pain relief days were also recorded in routine treatment group and Saussurea involucrata injection group. Results　Before treatment, the serum levels of Beclin-1, LC3, NF-κB p65, TNF-α, IL-1β and IL-10 were significantly higher in routine treatment group and Saussurea involucrata injection group than those in normal control group (P＜0.05). After 10-day treatment, the serum levels of Beclin-1, LC3, NF-κB p65, TNF-α and IL-1β were decreased in routine treatment group and Saussurea involucrata injection group, and which were lower in Saussurea involucrata injection group than those of routine treatment group. The serum levels of IL-10 increased after treatment in both groups on 10-day after treatment, and which was significantly higher in Saussurea involucrata injection group than that in routine treatment group (P＜0.05). The scores of APACHE Ⅱ and pancreas MCTSI decreased in routine treatment group and Saussurea involucrata injection group, and which was significantly lower in Saussurea involucrata injection group than that in routine treatment group (P＜0.05). The  hospital stay and relief days of abdominal pain were significantly lower in Saussurea involucrata injection group than those in routine treatment group (P＜0.05). Conclusion　Saussurea involucrata injection has an auxiliary therapeutic role in SAP patients, and its mechanism may be through inhibiting abnormal autophagy activation of pancreatic acinar cells and blocking inflammatory response NF-κB signaling pathway in SAP.

Key words: pancreatitis, acute necrotizing, autophagy, inflammation, NF-kappa B, severe acute pancreatitis, saussurea involucrata injection