| [Objective] To investigate brain pathological changes in early stage of acute necrotizing pancreatitis rat models and explore the protective effect of somatostatin combined with growth hormone on ANP rats. At the same time to explain the mechanism of brain damage in early stage of acute necrotizing pancreatitis, and provide a new trial for clinical therapy in ANP patient. [Methods] Male SD rats were randomly divided into six groups, each group 40 rats: Sham operation group; ANP group; ANP treated by normal saline group; ANP treated by Somatostatin group; ANP treated by growth hormone group; ANP treated by somatostatin in combined with growth hormones group. Retrograde pancreatic-bile duct injection of 3. 5% sodium taurocholate 2. 5 mL/kg, keeping the pressure 3. 4-3. 9kPa, was used to establish ANP rat models. Concentration of serum PLA2 endotoxin ET-1 NO IL-1 IL-6 TNF and expressions of brain tissue IL-6mRNA TNFamRNA were measured in each group respectively. At the same time, brain water content was measured by dry-wet method. Blood-brain barrier permeability was determined by brain Evan blue content. Electroencephalogram was examined in each group. Apoptosis of brain cell were observed by TUNEL test and flowcytometry . Pancreatic pathological evaluation graded with Schmidt criterion was performed, and assessed their relationship with brain damage. [Results] 7-days survival rate of ANP group was 0%, somatostatin treatment alone was 60%, combined group was 90%, the difference between combined group and ANP group was significant (p<0. 01). Concentration of serum PLA2 in the ANP group 230?4 pg/mL, while 143 + 30 pg/mL in the somatostatin group, 178 + 27 pg/mL in the growth hormone group, 127 + 32 pg/mL in the combined group, the difference between ANP group and each therapy group is significant (p<0. 01). Concentration of serum Endotoxin in the ANP group 250 13pg/mL vs. 72 + 12 pg/mL in the sham-operation group, while 78 + 18 pg/mL in the combined group, the difference betweenANP group and therapy group is significant (p<0.01). Concentration of serum TNF in the normal control group 41.5 5.7 pg/mL while 68.7 1.8 pg/mL in the ANP group , while 50.4 + 6.8 pg/mL in the somatostatin group, 54.2 + 3.8 pg/mL in the growth hormone group, 42.1+4.2 pg/mL in the combined group, the difference was significant compared with ANP group(p<0. 01) , but the combined hormone treatment cases had a dramatical effect. Concentration of serum IL-6 in the normal control group 40+ 16 pg/mL , while 63 15 pg/mL in the ANP group , 42+18 pg/mL in the somatostatin group, 48 + 14 pg/mL in the growth hormone group, 41 + 10 pg/mL in the combined hormone group, the differences are significant compared with ANP group(p<0. 01). Concentration of serum IL-1 61.8 + 12.4 pg/mL in the normal group vs. 147.3 + 9.5 pg/mL in the ANP group, while in the combined group 58.6+13.9 pg/mL, the difference was significant between ANP group and therapy group(p<0.01). IL-6mRNA and TNFamRNA in ANP rats was overexpressed in brain tissue compared with normal group, while after treatment of somatostatin and growth hormone the expression decreased. Concentration of serum ET-1 NO in the ANP group were remarkably elevated, and the balance between ET-1 and NO was disturbed, the ratio of ET-1/NO was also ascended. Concentration of serum ET-1 in the combined hormone group was 112.06 + 30. 9pg/mL, while 474. 3 + 43.9pg/mL in the ANP group, concentration of serum NO in the combined hormone group 88. 6?2.4g/L .while 235. 1?9. 4g/L in the ANP group, the difference is significant between ANP group and combined therapy group(p<0. 01). The ratio of ET-l/NO tended to balance, descend from 2. 02 to 1.26, near normal level 0. 95. Brain index and Evan blue content in the brain tissue were dramatically elevated. Brain index was highly elevated in ANP group 81. 02% + 0. 07%, while normal group79. 27%?. 16%, somatostatin group 80. 50% + 0.14%, growth hormone group80. 17%?. 53%, combined group 79. 65% + 0.23%, the difference between ANP group and combined group was significant (p<0.01...
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