RhGM-CSF对SAP大鼠肠黏膜屏障的保护性作用  

Protective effect of rhGM-CSF on intestinal mucosal barrier in rats with severe acute pancreatitis

作　　者：严苹 王清[2] 刘宇[2] 陈霞 Yan Ping;Wang Qing;Liu Yu;Chen Xia(Department of Gastroenterology,Affiliated Hospital of Southwest Medical University;Department of Hepatobiliary and Pancreatic Surgery,People’s Hospital of Leshan)

机构地区：[1]西南医科大学附属医院消化内科,泸州646000 [2]乐山市人民医院肝胆胰外科,乐山614000

出　　处：《重庆医科大学学报》2020年第9期1332-1335,共4页Journal of Chongqing Medical University

基　　金：四川省卫生和计划生育科研课题资助项目(编号:6PJ544)。

摘　　要：目的:探讨重组人粒细胞-巨噬细胞集落刺激因子(recombinant human granulocyte-macrophage colony-stimulating factor,rhGM-CSF)在重症急性胰腺炎(severe acute pancreatitis,SAP)肠黏膜屏障功能中的保护作用。方法:SD雄性大鼠36只,随机均分为3组:对照组(假手术组)、胰腺炎组(SAP组)、治疗组(SAP+rhGM-CSF组)。采用逆行胰胆管注射3%牛磺胆酸钠溶液制造重症胰腺炎大鼠模型,治疗组造模成功后,皮下注射rhGM-CSF 3μg/kg×5 d。5 d后处死大鼠,观察小肠组织形态学化、CD4+/CD8+值及肠道菌群结构改变。结果:SAP大鼠均无死亡,各组黏膜层出现明显病理改变。与胰腺炎组相比,治疗组小肠黏膜损伤明显减轻,上皮细胞基本完整,绒毛排列紧密,小肠腺加深且数量较多,杯状细胞和血管内皮细胞增多,黏膜厚度及肠壁水肿减轻;固有层CD8+淋巴细胞数明显减少,CD4+/CD8+值明显增高。胰腺炎组与对照组相比肠道菌群明显改变;治疗组双歧杆菌、乳酸杆菌均明显高于胰腺组[(6.34±4.64) ln/g vs.(3.71±4.96) ln/g,(9.52±3.86) ln/g vs.(5.17±2.14) ln/g,P<0.05],而大肠杆菌与肠球菌较胰腺组明显降低[(7.98±2.23) ln/g vs.(11.36±3.74) ln/g,(4.65±1.85) ln/g vs.(7.28±2.63) ln/g,P<0.05]。结论:rhGM-CSF能改善SAP肠黏膜免疫屏障功能。Objective:To explore the protective effects of recombinant human granulocyte-macrophage colony-stimulating factor(rhGM-CSF) on intestinal mucosal barrier in rats with severe acute pancreatitis. Methods:36 male SD rats were randomly and evenly divided into 3 groups:control group(sham operation group),severe acute pancreatitis model group(SAP group),and rhGM-CSF group(SAP rats treated with rhGM-CSF). The SAP rat models were established via retrograde injection of 3% sodium taurocholate to the pancreatic duct. Rats in rhGM-CSF group were hypodermically injected with rhGM-CSF with dose of 3 μg/kg per day for 5 days. All rats were executed on day 5,and the intestinal mucosal damage,the ratio of CD4+/CD8+and the composition of intestinal flora were analyzed. Results:There was no death in rats with SAP,and obvious pathological changes appeared in the mucosa of both groups.Compared with SAP group,damage to intestinal mucosa of rats in rhGM-CSF group were significantly reduced,the epithelial cells were almost intact,the villi were closely arranged,the small intestine gland was deepened and the number was larger,the numbers of goblet cells and vascular endothelial cells were increased,and the mucosal thickness and intestinal wall edema were alleviated;The number of CD8+lymphocytes in lamina propria was significantly reduced,and the CD4+/CD8+ratio was obviously higher. The intestinal flora in SAP group changed evidently compared with control group. The content of Bifidobacteria and Lactobacilli of observation group were higher than those of SAP group[(6.34±4.64) ln/g vs.(3.71±4.96) ln/g,(9.52±3.86) ln/g vs.(5.17±2.14) ln/g,P<0.05],while Escherichia coli and Enterococci were lower[(7.98±2.23) ln/g vs.(11.36±3.74) ln/g,(4.65±1.85) ln/g vs.(7.28±2.63) ln/g,P<0.05]. Conclusion:rhGM-CSF may improve effect of intestinal mucosal barrier in rats with severe acute pancreatitis.

关 键 词：重组人粒细胞-巨噬细胞集落刺激因子 肠黏膜屏障 急性重症胰腺炎 

分 类 号：R576[医药卫生—消化系统]