经皮导管引流减轻重症急性胰腺炎大鼠炎症损伤的实验研究  

Effect of percutaneous catheter drainage on inflammatory injury of severe acute pancreatitis rats

作　　者：陈光宇[1] 戴睿武[1] 闫洪涛[1] 陈涛[1] 黎冬暄[1] 汤礼军[1] 

机构地区：[1]中国人民解放军成都军区总医院全军普通外科中心,成都610083

出　　处：《重庆医学》2013年第19期2240-2242,共3页Chongqing medicine

基　　金：四川省青年科技创新团队基金资助项目(2011JTD0010)

摘　　要：目的探讨经皮导管引流(PCD)对重症急性胰腺炎(SAP)大鼠炎症反应的影响及意义。方法 42只Wistar大鼠随机分为假手术组(A组,10只)、逆行胰胆管注射牛磺胆酸钠诱导SAP大鼠模型(B组,16只)和SAP大鼠PCD治疗组(C组,16只),分别于建模后12h取血清及腹腔积液测定肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10及淀粉酶、蛋白酶水平,留取胰腺组织一部分制作石蜡切片行光镜下病理检查、一部分行蛋白质免疫印迹法(Western blotting)检测环氧化酶-2(COX-2)及诱导型一氮合酶(iNOS)表达。结果 B组大鼠血清淀粉酶、TNF-α、IL-6有显著升高(P<0.05),与A、C组比较IL-10无明显变化(P>0.05);相同时点的C组大鼠血清TNF-α、IL-6、淀粉酶和腹腔积液TNF-α、蛋白酶活性与B组比较,有明显下降(P<0.05),血清IL-10水平则显著升高(P<0.05),光镜病理检查提示C组大鼠胰腺病理损伤较A组大鼠明显改善,Western blotting结果显示C组大鼠胰腺组织COX-2和iNOS表达较A组大鼠明显下降(P<0.05)。结论 PCD可缓解SAP大鼠病情并减轻胰腺炎症损伤,其可能机制与引流出富含炎症细胞因子及胰酶等有害物质的腹腔积液从而抑制机体炎症反应并降低胰腺组织COX-2和iNOS的表达有关。Objective To study the effect of percutaneous catheter drainage（PCD） on inflammatory injury of severe acute pancreatitis（SAP） rats and its significance.Methods Forty-two Wistar rats were randomized into three groups：sham-operation control group（group A,n=10）,SAP model control group（group B,n=16） and PCD treated group（group C,n=16）.The levels of TNF-α,IL-6,IL-10,amylase,protease in blood and ascites were measured at 12th hour postoperatively,the expression of COX-2 and iNOS in the pancreatic tissue were detected by Western blotting,and pancreatic pathological changes were also observed.Results The serum levels of amylase,TNF-α,IL-6 in group B were significantly in creased（P0.05）,while serum IL-10 had not changed significantly compared with group A and C（P0.05）.Compared with group B,the serum levels of IL-6,amylase and ascites levels of TNF-α,protease were significantly decreased（P0.05）,serum level of IL-10 was increased（P0.05）.The light microscope pathological examination result showed that the pancreatic injury was alleviated in group C compared with group A.Western blotting indicated the expression of COX-2 and iNOS in the pancreatic tissue in group C were higher than that in group A（P0.05）.Conclusion PCD can relieve SAP-induced systemic and pancreatic injury by draining harmful ascites which contains inflammatory cytokine and trypsin,inhibiting inflammatory reaction and reducing the expression of COX-2 and iNOS in the pancreatic tissue.

关 键 词：重症急性胰腺炎 炎症反应 经皮导管引流 环氧化酶-2 诱导型一氮合酶 

分 类 号：R576[医药卫生—消化系统]