腹腔穿刺引流对早期重症急性胰腺炎大鼠肝脏TLR4表达的影响  

Effect of abdominal paracentesis drainage on TLR4 expression in liver of rats with early severe acute pancreatitis

作　　者：陈振宇 黄启林 孙红玉 刘立业 文艺 CHEN Zhen-yu;HUANG Qi-lin;SUN Hong-yu;LIU Li-ye;WEN Yi(Center of General Surgery,the General Hospital of Western Theater Command,Chengdu 610083,China)

机构地区：[1]西部战区总医院全军普通外科中心,四川成都610083

出　　处：《基础医学与临床》2020年第10期1342-1347,共6页Basic and Clinical Medicine

基　　金：国家临床重点专科项目(41732113)。

摘　　要：目的研究腹腔穿刺引流(APD)对早期重症急性胰腺炎(SAP)大鼠肝脏Toll样受体4(TLR4)表达的影响。方法将大鼠分为假手术(sham)组、SAP组(逆行胰胆管注射5%牛磺胆酸钠建立SAP模型)和SAP+APD组(在SAP基础上置入引流管并固定)。采用HE染色、全自动生化仪、ELISA法、real-time PCR和Western blot检测相关指标。结果24 h后,SAP组大鼠肝脏和胰腺病理损伤较sham组明显加重,病理评分明显增高(P<0.05),血清淀粉酶和脂肪酶活性、AST、ALT、总胆红素、胆汁酸水平以及TNF-α、IL-1β、HMGB1的水平也明显升高(P<0.05);SAP组大鼠肝脏TLR4的mRNA和蛋白表达,NF-κB p65的蛋白表达和磷酸化水平以及TNF-α、IL-1β的表达较sham组均明显增加(P<0.05),实施APD干预后上述指标均得到明显缓解(P<0.05)。结论实施APD能显著减少SAP早期大鼠肝脏TLR4的表达,抑制下游NF-κB炎性信号通路的激活,从而减轻肝脏损害程度。Objective To investigate the effect of abdominal paracentesis drainage(APD)on TLR4 expression in the liver of rats with early severe acute pancreatitis(SAP)and its significance.Methods The rats were randomly divided into sham operation group(sham group),SAP group(SAP model was established by retrograde injection of 5%sodium trasulfide cholate into the pancreatic bile duct)and SAP+APD group(drainage tube was placed and fixed on the basis of SAP).HE staining,automatic biochemical analyzer,ELISA,real-time PCR and Western blot were used to detect relevant indexes.Results Compared with sham group,the pathological injury of liver and pancreas were significantly worse and the pathological scores were significantly increased in the SAP group(P<0.05),the activityies of serum amylase and lipase,serum indicators related to liver function,and serum levels of TNF-α,IL-1βwere also significantly increased(P<0.05);The mRNA and protein expressions of TLR4,the protein expression of NF-κB p65,TNF-α,IL-1β,and the phosphorylation levels of NF-κB p65 in liver tissues in the SAP group were significantly up-regulated than those in the sham group(P<0.05);After APD intervention,the above indicators were significantly alleviated(P<0.05).Conclusions Implementation of APD can significantly decrease the expression of TLR4 in liver tissue of rats with early SAP,inhibit the activation of downstream NF-κB signaling pathway,thus relieve the degree of liver injury.

关 键 词：重症急性胰腺炎 腹腔穿刺引流 肝损伤 TOLL样受体4 高迁移率族蛋白B1 

分 类 号：R657.5[医药卫生—外科学]