中性粒细胞弹性蛋白酶在重症胰腺炎急性肺损伤中的表达及大黄附子汤的干预作用  

Intervention effects of Dahuangfuzi decotion on expression of neutrophil elastase in rats with severe pancreatitis-acute lung injury

作　　者：路小光[1] 战丽彬[2] 康新[1] 范治伟[1] 白黎智[1] 刘莉[1] 康利民[1] 纪春阳[1] 

机构地区：[1]大连大学附属中山医院急诊外科,116001 [2]大连医科大学附属第二医院中医科

出　　处：《中华实验外科杂志》2010年第12期1901-1904,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（30672767、30971626）;辽宁省科技厅国际科技合作计划资助项目

摘　　要：目的 观察中性粒细胞弹性蛋白酶（NE）在重症急性胰腺炎并急性肺损伤（SAP-ALI）中的表达及大黄附子汤的干预作用.方法 健康SD大鼠80只,按体质量随机分成4组：假手术组（n=19）、SAP-ALI组（n=21）、NE处理组（n=20）及大黄附子汤治疗组（治疗组,n=20）.假手术组开腹后行空肠造瘘,翻动胰腺数次后关腹;SAP-ALI组在假手术组基础上经胰胆管逆行注入4%牛磺胆酸钠（1 ml/kg）,建立SAP-ALI模型;NE处理组造模后静脉输注NE 0.5 U/100 g,其他同SAP-ALI组;治疗组在NE处理组基础上经空肠造瘘管注入大黄附子汤10 ml.酶联免疫吸附试验（ELISA）法检测肺泡灌洗液和血清的NE含量及血清肿瘤坏死因子（TNF）-α、白细胞介素（IL）-1β含量.逆转录-聚合酶链反应（RT-PCR）、Western b1ot法分别检测肺组织NE mRNA和蛋白表达,同时观察胰腺和肺组织湿/干重比和病理形态学变化.结果 NE处理组BALF和血清NE含量及血清TNF-α、IL-1β含量均较SAP-ALI组大鼠明显增加（P〈0.05）.NE处理组肺组织NE mRNA表达较SAP-ALI组显著升高.经大黄附子汤治疗后BALF和血清NE含量、血清TNF-α、IL-1β含量及肺组织中NE mRNA表达均较NE处理组明显降低（P〈0.05）.结论 NE的过度释放参与了SAP-ALI的发病过程,大黄附子汤可通过抑制NE的释放,降低血清TNF-α、IL-1β含量,减轻肺损伤程度.Objective To investigate the intervention effects of Dahuangfuzi decotion on the expression of neutrophil elastase （NE） in rats with severe pancreatitis-acute lung injury （SAP-ALI）.Methods Eighty health SD rats were randomly divided into four groups： sham operation group （ n = 19）,SAPALI group （ n = 21 ）,NE group （ n = 20）,and Dahuangfuzi decotion-treated group （ treatment group,n =20）.The blood gas analysis was made,tumor necrosis factor （TNF）-α and interleukin （IL）-1β in blood were measured with ELISA at the 24th h after the establishment of SAP-ALI model.The expression of NE in the lung tissues was detected by reverse transcription-polymerase chain reaction （RT-PCR） and Western blotting,and the contents of NE in BALF and serum were determined when the animals were sacrificed as the 24th h after operation.The wet-to-dry （W/D） ratio of lung tissues and pathomorphological changes in the pancreatic and lung tissues were observed.Results The contents of NE in the lung tissue,BALF and serum of NE group were significantly higher than those in SAP-ALI group （P〈0.05 ）.The contents of TNF-α and IL-1β in NE group were also significantly higher than those in SAP-ALI group.The contents of NE in the lung tissue,BALF and serum,and TNF-α and IL-1β in treatment group were significantly lower than those in NE group.Conclusion Neutrophil activation and excessive release of NE were involved in the pathogenesis of SAP-ALI.Dahuangfuzi decoction can significantly reduce the severity of SAP-ALI in rats by inhibiting the elevation of NE and down-regulating the expression of TNF-α and IL-1β.

关 键 词：重症急性胰腺炎 急性肺损伤 中性粒细胞 弹性蛋白酶 大黄附子汤 

分 类 号：R285.5[医药卫生—中药学]