大鼠重症急性胰腺炎时几石、TNF-α变化及小剂量多巴胺干预作用的实验研究  

Changes of blood IL-6, TNF-α and effects of low dose dopamine in rats with severe acute pancreatitis

作　　者：彭新刚[1] 张顺[2] 卢云[2] 

机构地区：[1]青岛大学医学院附属医院急诊普外科,青岛266003 [2]青岛大学医学院附属医院肝胆外科,青岛266003

出　　处：《国际外科学杂志》2007年第11期742-745,共4页International Journal of Surgery

基　　金：本课题受青岛市科学技术局2001年科技发展指导计划资助（No.ZD01-088）

摘　　要：目的探讨大鼠重症急性胰腺炎时IL-6、TNF-α的变化及小剂量多巴胺对重症急性胰腺炎（SAP）的治疗作用。方法将Wistar60只大鼠随机分为三组，假手术组、SAP组和多巴胺组。假手术组（n=20）开腹后仅轻揉胰腺及十二指肠，其余两组向大鼠胰管注射牛磺胆酸钠建立SAP动物模型，多巴胺治疗组（n=20）静脉给予多巴胺（5ug·kg^-1·min^-1），SAP组（n=20）静脉给予生理盐水。分别于实验前和实验后2、4、6、12h经颈静脉取血，采用双抗体夹心ELISA法测定血清中白细胞介素6（IL-6）、肿瘤坏死因子仅（TNF-α）水平，术后12h处死大鼠，取胰腺组织行病理检查。结果实验前假手术组、SAP组、多巴胺组的血清IL-6和TNF-α水平差异无显著性（t=0．64～1．38，P〉0．05）。术后IL-6、TNF-α水平均升高，差异有显著性（t=3．12～69．46，P〈0．01）；多巴胺组血清IL-6、TNF-α水平较SAP组低，差异有显著性（t=6．23～32，32，P〈0．01）。胰腺病理组织学评分多巴胺组明显低于SAP组，差异有显著性（t=3．92～9．94，P〈0．01）。结论SAP时机体血IL-6、TNF-α水平明显升高是加重SAP病情的损伤性因子，而小剂量多巴胺干预可降低上述炎症介质水平，从而减轻胰腺病理损害，为阻断SAP病情发展的有效药物之一，其机制可能与小剂量多巴胺能增加胰腺血流量和降低胰腺微血管通透性有关。Objective To study the changes of blood IL-6, TNF-α and evaluate the therapeutic mechanism of low dose dopamine in severe acute pancreatitis （SAP）. Methods Sixty Wistar rats were divided in- to 3 groups： false operation group （group I）, dopamine treatment group （group Ⅱ） and SAP control group （ group Ⅲ ）. An animal model of acute pancreatitis was established by injecting sodium taurocholate into the pancreatic duct. The operation of Group Ⅰ （ n = 20） was only opened abdomen. Group Ⅱ （ n = 20） ： 5 ug. kg^-1· min^-1 was dopamine given intravenously while for control one （n = 20）, normal saline was given. Blood samples were taken from the jugular vein before the experiment and at 2,4,6,12 hours after the experiment. The IL-6 and TNF-α were detected by ELISA technique. The pancreas was examined histologically 12 hours after the treatment. Results The serum levels of IL-6 and TNF-α were similar before operation （ t = 0.64, 1.38,P 〉0.05） ,but the levels were higher after operation. The levels of IL-6 and TNF-α of the dopamine treatment group were lower than that of the SAP control one ,the difference was significant （t = 6.23-32.32, P 〈 0.01 ）. The grade of pancreatic histopathology of dopamine group was obviously lower than that of the SAP group （ t = 3.92 - 9.94, P 〈 0.01 ）. Conclusions The cytokines （ TNF-α, IL-6 ） play an important role in the development of acute pancreatitis. While low - dose dopamine may reduce the inflammatory reaction of acute pancreatitis, perhaps because low dose of dopamine not only increases the blood flow of pancreatic microvessel but also reduces its permeability.

关 键 词：重症急性胰腺炎 多巴胺 白细胞介素-6 肿瘤坏死因子-Α 

分 类 号：R57[医药卫生—消化系统]