CO_2气腹对SD大鼠重症急性胰腺炎炎性细胞因子的表达及胰腺病理变化的影响  

Effect of Carbon Dioxide Pneumoperitoneum on the Expression of Proinflammatory Cytokines and Histopathological Changes of the Pancreas in SD Rats with Severe Acute Pancreatitis

作　　者：秦春宏[1] 张学林[1] 贺宏杰[1] 吴江[1] 

机构地区：[1]南华大学附属第二医院普外科,衡阳421001

出　　处：《中国微创外科杂志》2010年第3期273-277,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：湖南省卫生厅2007年度科研计划项目基金资助;编号:B2007112

摘　　要：目的探讨腹腔镜手术时CO2气腹对SD大鼠重症急性胰腺炎(severe acute pancretitis,SAP)胰腺局部病变及血淀粉酶、炎症细胞因子IL-6、TNF-α、C-反应蛋白(C-reactive protein,CRP)及核转录因子-κB(NF-κB)的影响。方法雄性SD大鼠50只,随机分为3组:Ⅰ组20只(CO2组,5%牛磺胆酸钠胆胰管逆行注射方法建立SAP动物模型后,腹腔镜气腹机向大鼠腹腔内注入CO2,压力12mm Hg,维持30min);Ⅱ组20只(开腹组,建立SAP动物模型后关腹,不充入CO2);Ⅲ组10只(对照组,仅开腹翻动胰腺后关腹)。各组均于术后2.5h处死动物,测定血淀粉酶、IL-6、TNF-α及CRP的变化,进行胰腺组织病理学检查,并用免疫组化法检测NF-κB的变化。结果Ⅰ、Ⅱ、Ⅲ组病理组织学评分值分别为(1.90±0.37)分、(1.75±0.26)分、(0.00±0.00)分,差异有统计学意义(F=365.91,P=0.000),但Ⅰ组与Ⅱ组比较,差异无统计学意义(q=2.372,P>0.05)。与Ⅲ组相比,Ⅰ组和Ⅱ组血清淀粉酶、IL-6、TNF-α均明显升高(P<0.05)。与Ⅱ组相比,Ⅰ组IL-6降低(P<0.05),淀粉酶明显升高(P<0.05),Ⅰ组与Ⅱ组TNF-α、CRP差异无统计学意义(P>0.05)。Ⅰ、Ⅱ组与Ⅲ组NF-κB阳性表达值分别为3.91±0.81、3.55±0.76、0.92±0.51,差异有显著性(F=56.59,P=0.000),Ⅰ组与Ⅱ组比较,NF-κB表达差异有统计学意义(q=3.387,P<0.05),Ⅰ、Ⅱ组与Ⅲ组比较,NF-κb阳性表达值有显著性差异(q=14.764,P<0.05;q=11.999,P<0.05)。结论CO2气腹对SD大鼠SAP胰腺病理变化无明显影响。SAP时CO2气腹对SD大鼠TNF-α、CRP的表达无明显影响,对IL-6的表达有一定的抑制作用,能增强NF-κB阳性表达。Objective To examine the effect of carbon dioxide pneumoperitoneum on local pathological changes of the pancreas,as well as the levels of serum amylase,IL-6,TNF-α,CRP,and NF-κB in SD rats with severe acute pancreatitis（SAP）.Methods A total of 50 healthy male SD rats were randomly divided into 3 groups：Group Ⅰ（20 rats）：CO2 pneumoperitoneum group,SAP was induced by injecting 5% sodium taurocholate retrogradely through the common bilio-pancreatic duct,afterwards,CO2 pneumoperitoneum was established at 12 mm Hg and maintained for 30 min;Group Ⅱ（20 rats）：laparotomy group,no CO2 was infused after the SAP sample was established;Group Ⅲ（10 rats）：sham operation group,abdomen was opened for 30 minutes without any treatments.Two and a half hours after the surgical procedures,the animals were killed and the blood samples were gathered to determine the levels of serum amylase,IL-6,TNF-α,CRP,and NF-κB;pancreatic tissues was collected as well for histopathologic examination.Results The mean histopathological score of the GroupsⅠ and Ⅱ was significantly higher than that of the Group Ⅲ（1.90±0.37 and 1.75±0.26 vs 0.00±0.00,F=365.91,P=0.000）,no significant difference was detected between the Groups Ⅰ and Ⅱ（q=2.372,P〉0.05）.The levels of serum amylase,IL-6,and TNF-α in Group Ⅲ were significantly lower than those in the Groups Ⅰ and Ⅱ（P〈0.05）.Compared with those in the Group Ⅱ,Group Ⅰ showed significantly lower IL-6 level,but significantly higher serum concentration of amylase（P〈0.05 for both）.No significant difference was observed in TNF-α and CRP levels between Groups Ⅰ and Ⅱ（P〉0.05）.The expression level of NF-κB was significantly different among the Groups Ⅰ,Ⅱ,and Ⅲ（3.91±0.81,3.55±0.76,and 0.92±0.51,respectively;F=56.59,P=0.000;Group Ⅰ vs Ⅱ：q=3.387,P〈0.05;Groups Ⅰ vs Ⅲ：q=14.764,P〈0.05;Groups Ⅱ vs Ⅲ：q=11.999,P〈0.05）.Conclusions CO2 pneumoperitoneum has no adverse effects on the histopathology of the pancre

关 键 词：重症急性胰腺炎 CO2气腹 白细胞介素 肿瘤坏死因子 C-反应蛋白 核转录因子 SD大鼠 

分 类 号：R657.51[医药卫生—外科学]