CO2气腹对大鼠重症急性胰腺炎胰腺病理及IL-6、E-选择素、P-选择素的影响  

Effect of carbon dioxide pneumoperitoneum on serum levels of IL-6, E-selectin and P-selectin and pancreatic pathology in severe acute pancreatitis

作　　者：杨文军[1] 贺红杰[1] 秦春宏[1] 

机构地区：[1]南华大学附属第二医院普外科,衡阳421001

出　　处：《国际外科学杂志》2010年第9期603-606,F0003,共5页International Journal of Surgery

摘　　要：目的 研究腹腔镜手术时CO2气腹对SD大鼠重症急性胰腺炎病变局部、血淀粉酶、白细胞介素-6（IL-6）、E-选择素和P-选择素的影响. 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12 mm Hg,维持30 min）;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2.5 h处死动物,取静脉血测定血淀粉酶、白细胞介素-6、E-选择素和P-选择素的水平,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组病理学评分、血清淀粉酶、白细胞介素-6、E-选择素和P-选择索均明显升高,差异有统计学意义（P=0.000）.与SAP组相比,CO2气腹组血白细胞介素-6明显降低,差异有统计学意义P=0.000;病理学评分（P=0.294）、血清淀粉酶（P=0.073）、E-选择素（P=0.126）和P-选择素（P=0.213）的差异无统计学意义. 结论 对于SAP大鼠,CO2气腹对白细胞介素-6有一定的抑制作用;对胰腺病理变化及E-选择素和P-选择素无明显影响.Objective To examine the effect of carbon dioxide pneumoperitoneum on local pancreas pathological changes, serum levels of amylase, IL-6, E-selectin and P-selectin in rats with severe acute pancreatitis （SAP）. Methods Fifty healthy male SD rats were randomly divided into 3 groups： CO2 experiment 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 mmHg for 30 min; SAP group （ n = 20）： The rats were treated as same as CO2 experiment group, excepting CO2 pneumoperitoneum; Control group （n = 10）： Abdomen was incised and nothing was done to duodenum and pancreas except for moving them softly. The blood samples were gathered for examining serum levels of amylase, IL-6, E-selectin and P-selectin, and histopathologic examination of pancreas was done.Results Compared with control group, the pancreatic pathologic histology score, serum levels of amylase,IL-6, E-selectin and P-selectin were significantly higher in the CO2 experiment group and SAP group （P =0.000）. The levels of IL-6 were significantly lower in CO2 experiment group compared to SAP group （P =0. 000）. There was no significant difference between CO2 experiment group and SAP group in pancreatic pathologic histology score（ P =- 0.294）, the levels of serum amylase （ P = 0.073 ）, E-selectin and P-selectin. Conclusions CO2 pneumoperitoneum has no adverse effect on the changes of pathological histopathology and the levels of IL-6, E-selectin and P-selectin in SD rats with SAP.

关 键 词：重症急性胰腺炎 CO2气腹 白细胞介素-6 E-选择素 P-选择素 

分 类 号：R576[医药卫生—消化系统]