CO_2气腹对大鼠重症急性胰腺炎胰腺病理及IL-1、IL-6、CD11a/CD18和CD11b/CD18的影响  

Effects of Carbon Dioxide Pneumoperitoneum on Serum Levels of IL-1,IL-6,and CD11a/CD18 and CD11b/CD18 Expression and Pancreatic Pathology in Severe Acute Pancreatitis

作　　者：贺红杰[1] 秦春宏[1] 张学林[1] 吴江[1] 

机构地区：[1]南华大学附属第二医院普外科,湖南衡阳421001

出　　处：《中国普外基础与临床杂志》2010年第2期147-151,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：湖南省卫生厅2007年度科研计划项目基金(项目编号: B2007112)~~

摘　　要：目的研究腹腔镜手术时CO2气腹对Sprague-Dawley(SD)大鼠重症急性胰腺炎(SAP)胰腺组织病理学改变、血淀粉酶、炎症细胞因子(IL-1和IL-6)和可溶性黏附分子(CD11a/CD18和CD11b/CD18)的影响。方法雄性SD大鼠50只,随机分为3组:CO2气腹组(n=20),5%牛磺胆酸钠胆胰管逆行注射方法制备SAP动物模型后,以气腹机向大鼠腹腔内注入CO2〔压力12mmHg(1mmHg=0.133kPa),维持30min〕;SAP组(n=20):建立SAP模型后关腹,不充入CO2;单纯手术组(n=10):仅开腹翻动胰腺后关腹。各组均于术后2.5h处死动物,取静脉血测定血淀粉酶、IL-1和IL-6水平及CD11a/CD18和CD11b/CD18的表达阳性率,并进行胰腺组织病理学检查。结果与单纯手术组相比,CO2气腹组和SAP组胰腺组织病理学评分、血清淀粉酶、IL-1和IL-6水平及CD11a/CD18和CD11b/CD18表达阳性率均明显升高,差异有统计学意义(P=0.000)。与SAP组相比,CO2气腹组血IL-1和IL-6水平明显降低,差异有统计学意义(P=0.000);而胰腺组织病理学评分(P=0.294)、血清淀粉酶水平(P=0.073)、CD11a/CD18(P=0.155)和CD11b/CD18(P=0.201)表达阳性率的差异无统计学意义。结论对于SAP大鼠,CO2气腹对IL-1和IL-6水平有一定的抑制作用;而对胰腺病理变化及CD11a/CD18和CD11b/CD18表达阳性率无明显影响。Objective To examine the effects of carbon dioxide （CO2） pneumoperitoneum on local pancreas pathological changes,serum levels of amylase,IL-1,IL-6,and the positive rate of dissolubility adhesion molecule （CD11a/CD18 and CD11b/CD18） expression in rats with severe acute pancreatitis （SAP）. Methods Fifty healthy male Sprague-Dawley （SD） rats were randomly divided into 3 groups：CO2 pneumoperitoneum group （n=20）：SAP was induced by injecting 5% sodium taurocholate through retrogradely common biliopancreatic ducts via duodenal papilla,and then CO2 pneumoperitoneum was established at a pressure of 12 mm Hg （1 mm Hg=0.133 kPa） for 30 min; SAP group （n=20）：The rats were treated as same as CO2 pneumoperitoneum group,except CO2 pneumoperitoneum; Simple operation group （n=10）：Laparotomy was performed and nothing was done to duodenum and pancreas except for moving them softly. The blood samples were collected for examining serum levels of amylase,IL-1,IL-6,and the positive rates of CD11a/CD18 and CD11b/CD18 expression,and histopathologic examination of pancreas was performed. Results Compared with simple operation group,the pancreatic pathologic histology score,serum levels of amylase,IL-1,IL-6,and the positive rates of CD11a/CD18 and CD11b/CD18 expression were significantly higher in CO2 pneumoperitoneum group and SAP group （P=0.000）. The levels of IL-1 and IL-6 were significantly lower in CO2 pneumoperitoneum group as compared to SAP group （P=0.000）. There was no significant difference between CO2 pneumoperitoneum group and SAP group in pancreatic pathologic histology score （P=0.294）,the level of serum amylase （P=0.073）,the positive rates of CD11a/CD18 （P=0.155） and CD11b/CD18 expression （P=0.201）. Conclusion CO2 pneumoperitoneum has inhibitory effect on the levels of IL-1 and IL-6,rather than the positive rates of CD11a/CD18 and CD11b/CD18 expression in SD rats with SAP.

关 键 词：重症急性胰腺炎 CO2气腹 白细胞介素 可溶性黏附分子 大鼠 

分 类 号：R657.51[医药卫生—外科学]