乌司他丁、地塞米松对急性坏死性胰腺炎大鼠TNF-α、IL-10和GR的影响  

Influence of Ulinnastatin and Dexamehasone on blood TNF-α, IL-10 and GR in rats with acute necrotizing pancreatitis

作　　者：刘纳新[1] 刘存丽[2] 施红旗[1] 陈周浔[1] 周蒙滔[1] 朱耶凡[1] 余震[1] 

机构地区：[1]温州医学院第一附属医院普外科,浙江温州325000 [2]温州医学院第一附属医院检验科,浙江温州325000

出　　处：《肝胆胰外科杂志》2008年第5期336-339,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：吴阶平医学基金资助项目(WJP01)

摘　　要：目的探讨急性坏死性胰腺炎大鼠(acute necrotizing pancreatitis,ANP)TNF-α、IL-10和糖皮质激素受体(glucocorticoid receptor,GR)的变化规律及乌司他丁(ULI)、地塞米松(DEX)干预对上述指标的影响。方法80只SD雄性大鼠随机分为5组:①假手术组(S组,n=16);②急性胰腺炎组(A组,n=16);③ULI组(U组,n=16);④DEX组(D组,n=16);⑤ULI+DEX组(UD组,n=16)。除S组外,其余各组均通过逆行胰胆管注射5%牛磺胆酸钠制作ANP模型。分别在模型制作成功后8h和12h,观察大鼠胰腺病理改变判断ANP严重程度;酶法检测血清淀粉酶(amylase,AMY)水平,ELISA检测血清TNF-α、IL-10蛋白水平以及RT-PCR检测全血有核细胞GR的mRNA表达。结果①A组大鼠表现为典型ANP病理改变,包括间质水肿、炎细胞浸润、出血和胰腺坏死。ULI和DEX单用或两药联用均可减轻ANP的炎症反应,两者联合应用可能存在协同效应。②A组血清TNF-α、IL-10显著高于S组(P<0.01),ULI和DEX无论是单独应用还是联合应用均可使TNF-α下降以及IL-10上升。③在术后8h和12h,U组、D组GRmRNA表达显著低于S组(分别为P<0.05和P<0.01);术后12hUD组GRmRNA组显著高于A组(P<0.05)。结论TNF-α、IL-10以及GR的改变与ANP的炎症反应存在相关性,而ULI和DEX可能通过影响这些因素达到缓解ANP的作用;两药联合应用可能存在协同作用。Objective To investigate the changes of TNF-α, IL-10, glucocorticoid receptor （GR） in rats with acute necrotizing pancreatitis （ANP） and the influence of Ulinnastatin and Dexamehasone on these parameters in ANP rats. Methods Eighty male Sprague-Dawley （SD） rats were divided into five groups： （1）sham- operation group （group S, n=16） ;（2）acute-necrotizing-pancreatitis group （group A, n=16）; （3）ULl-treated group （group U, n=16）; （4）DEX-treated group （group D, n=16）, （5）ULI-and-DEX-treated group （group UD, n= 16）. ANP model was induced by intergraded injection of 5% sodium taurocholate to biliopancreatic duct in the rats except for group S. After the experiment model was established for 8 h and 12 h, the severity of ANP patholugy was confirmed with histological morphology; the serum AMY level was measured with enzymatic method; the serum TNF-α, IL-10 levels were detected with enzyme-linked immunosorbent assay （ELISA）; and the mRNA expression of GR in blood was measured with semiquantitative RT-PCR. Results （1）Typical ANP pathological changes were found in group A, including interstitial edema, infiltration of inflammatory cells, hemorrhage and parenchyma necrosis. The inflammation was relieved in ANP rats treated with Ulinnastatin, Dexamehasone or the combination of both drugs; the synergistic effect was found in group UD. （2）The concentration of serum TNF-α, IL-10 in group A were increased obviously than that in group S （P〈0.01）. The concentration of serum TNF-α decreasing and IL-10 increasing in rats were induced by the single or combination usage of Ulinnastatin and Dexamehasone （P〈0.01 or P〈0.05）. （2）The mRNA expression of blood GR in group U and group D was lower significantly than that in group S 8 h or 12 h after the operation （P〈0.01 or P〈0.05）; furthermore, the GR expression level in group UD 12 h after the operation was higher than that of group A （P〈0.05）. Conclusion The changes of TNF-α, IL-10, GR are in

关 键 词：乌司他丁 地塞米松 急性坏死性胰腺炎 肿瘤坏死因子α 白细胞介素10 糖皮质激素受体 大鼠 

分 类 号：R657.51[医药卫生—外科学]