| Objective: SAP( Severe Acute Pancreatitis) is a severe acute abdomen of surgery, which often episodes emergency and is often complicated by multiple organ dysfunction syndrome( MODS ). Many of patients of SAP are complicated by acute renal injury , and part of them develop into acute renal failure ( ARF ). The mortality rate of SAP complicated with ARF is about 80%. So it has been a important cause of death. And it has been a hot spot of investigation by many scholars. By setting up SAP model in SD rat , detecting the concentration of blood uria nitrogen, creatinine, PGI2, TXA2 and observing the dose and color of Ascitic fluid, the changes of pancreas and renal, we study the role of TXA2, PG^ in SAP with renal damage, and observe the effects of ulinastatin(UTI) , Rhubarb on SAP .Methods : SAP model was induced by retrograde injection of 5% sodium tanrocholate to pancreatic duct. We setted up administration by external jugular vein and by stoma on jejunum . 180 healthy SD rat randomly were divided into 20 groups: fame 2h 6h 12h groups, SAP 2h 6h12h groups (fame treated groups, F), ulinastatin 2h 6h 12h 24h treated groups (W 2h 6h 12h 24h ), rhubarb treated groups (Dh 2h 6h 12h 24h ) , ulinastatin+rhubarb treated groups(W+Dh 2h 6h 12h 24 ).Then we measured the serum levels of TXA2, PGI2, AMY, LIP, BUN, Cr, pancreatic index and blind pancreatic pathologic grades.Results: Results: 1.Comparison of SAP and F: 1.1. little and clear ascites in F groups and a lot of red ascites in SAP group. The time longer, the more of ascites. 1.2. The changes of pathomorphology : we found that pancreas had been edema, hyperemia, necrosis in SAP groups. Under microscope we had found edema, hyperemia, necrosis in acinus and interstitial of pancreas pancreatic. Index and pathologic scores increased significantly too (P<0.05). And we had found bleed widespread in renal glomerulus, and red cell and epithelial cell cast in renal tubules. The time longer, the severer. 1.3 Level of AMY, LIP, BUN, Cr in SAP groups' serum increase significantly (P<0.05).1.4 Level of TXA2 PGI2 in SAP groups' serum increase significantly too. And the levels of TXA2 PGI2 of SAP groups was stepping higher than the levels of F groups . (PO.05); 2. Comparison of the groups under treatment with SAP groups: 2.1 The dose of ascitic decrease significantly in W, Dh, W+Dh. 2.2 the change pathomorphology of pancreas and renal relieved significantly in W, Dh, W+Dh. 2.3 Level of AMY, LIP, BUN, Cr in groups of treatments decreased significantly comparedwith SAP. 2.4 Level of TXA2 in treatments groups' serum decrease significantly too (PO.05); Level of PGF in SAP manifested a decreasing tendency. And we still could not dawn significantly conclusion.Conclusions: l.The method of intragrade injecting 5% sodium taurocholate to pancreatic duct to induce SAP model with renal damage is duplicated, valuable and reliable. 2. TXA2, TXA2/PGl2 play important roles in pathogence of SAP compared with renal damage. Their serum levels all increased, and are harmful to organs. 3.The result of our experiment shows PGI2 plays a role of protection. 4.ulinastatin and thubarb have potential therapeutical influence to SAP complicated with renal damage, they can modify pancreatic, microcirculation dysfunction and improve pancreatic and renal pathologic change. Combination maybe more useful. We study the role of vascular active substance in acute pancreatitis with renal damage. And our conclusion may be useful for the clinical treatments of acute pancreatitis.
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