乳糜池结扎对大鼠急性胰腺炎肺损伤的影响  

Effect of Cisterna Chyli Ligation on Acute Pancreatitis-Associated Lung Injury in Rats

作　　者：张大鹏[1] 李阳[1] 崔乃强[1] 王丰[2] 

机构地区：[1]天津市南开医院外二科,天津300100 [2]天津市中西医结合急腹症研究所,天津300100

出　　处：《中国中西医结合外科杂志》2013年第4期393-396,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:通过制备大鼠急性胰腺炎模型,研究乳糜池结扎对急性胰腺炎肺损伤的影响。方法:雄性Wistar大鼠,随机分为:假手术组(A组)、急性胰腺炎组(B组)、乳糜池结扎组(C组)、急性胰腺炎并乳糜池结扎组(D组),C、D组予乳糜池结扎,A、B组予剖腹手术后关腹,48h后记录大鼠存活率;B、D组采用连续6次皮下注射雨蛙素、间隔1h的方法建立急性胰腺炎模型,A、C组予生理盐水对照;各组大鼠造模后6h处死,分别检测肺组织髓过氧化物酶(MPO)水平、肺泡灌洗液(BALF)中蛋白含量和IL-1、ICAM-1、血管生成素-2(ANG-2)水平,并观察胰腺、末端回肠、肺组织的病理改变。结果:A组术后存活率90%、B组为80%、C组为80%、D组为90%,B组肺组织MPO水平、BALF蛋白含量、IL-1水平显著高于A组,(P<0.05);D组肺组织MPO水平、BALF蛋白含量、Ang-2水平显著低于B组,(P<0.05);B、C、D组胰腺、末端回肠间质具有不同程度水肿伴炎细胞浸润,D组肺泡壁断裂,肺泡腔可见炎细胞浸润,但较B组损伤明显减轻。结论:阻断肠淋巴途径可通过减少急性胰腺炎大鼠中性粒细胞的聚集,减轻肺部炎症反应,保护肺泡-毛细血管屏障。Objective To investigate the lung injury through the model of cisterna chyli ligation in rats with acute pancreatitis （AP）.Methods Forty male Wistar rats were randomly divided into four groups：group A （sham operation）;group B （acute pancreatitis）;group C（cisterna chyli ligation）;group D （cisterna chyli ligation plus acute pancreatitis）.Groups A and B underwent laparotomy only.In groups C and D,mesenteric lymph flow from gut into bloodstream was blocked by cisterna chyli ligation.The survival situation at 48 h was recorded.After 48 h,saline （154 mmol/L NaCl） only was injected in groups A and C.In groups B and D,acute pancreatitis was induced by subcutaneous cerulein injection （50 μg/kg） six times at one-hour intervals.All animals were sacrificed at 6 h after modeling.Bronchoalveolar lavage fluid （BALF） was harvested for measuring IL-1,ICAM-1,Ang-2 and protein content.The samples of pancreas,terminal ileum and lung were collected for examination under light microscopy.Lung myeloperoxidase （MPO） activity was also measured.Results For groups A,B,C,and D,the postoperative survival rate was 90,80,80 and 90%,respectively.Lung MPO activity and the BALF level of protein and IL-1 in group B increased significantly comparing with those in group A （all P 0.05）.Compared to group B,lung MPO activity and the BALF level of protein and Ang-2 were significantly decreased in group D （all P 0.05）.Histological changes were observed in the pancreas and terminal ileum of groups B,C and D：interstitial edema and infiltration of numerous inflammatory cells in different degree.In group D,infiltration of inflammatory cells in the lung and destruction of alveolar wall were significantly less than those in group B.Conclusion The blockage of lymph flow from gut into bloodstream can protect alveolar-capillary barrier and relieve the degree of lung injury by reducing lung inflammation.Intestinal lymphatic pathway plays an important role in the pathway from intestine to lung in the traditional Chin

关 键 词：急性胰腺炎 肺损伤 乳糜池结扎 炎性细胞因子 肺泡灌洗液 

分 类 号：Q95-33[生物学—动物学]