腹腔穿刺引流对重症急性胰腺炎大鼠相关肝损伤的保护作用  

Protective effect of abdominal paracentesis drainage against liver injury in rats with severe acute pancreatitis

作　　者：朱玉乾 郑传明[2] 宁长青[1] ZHU Yu-qian;ZHEN Chuan-ming;NING Chang-qing(Department of Emergency Surgery,Fuyang Hospital Affiliated to Anhui Medical University,Fuyang Anhui 236000;Department of Emergency Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]安徽医科大学附属阜阳人民医院急诊外科,安徽阜阳236000 [2]蚌埠医学院第一附属医院急诊外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2023年第10期1329-1332,共4页Journal of Bengbu Medical College

基　　金：安徽省高校自然科学研究重点项目(KJ2019A0385)。

摘　　要：目的:探讨腹腔穿刺引流(APD)对重症急性胰腺炎(SAP)大鼠相关肝损伤的影响。方法:将30只SD大鼠随机分为SAP未处理组(SAP组)、SAP APD组(APD组)和假手术组(SHAM组),每组10只。通过应用牛磺胆酸钠诱导重症急性胰腺炎模型,利用ELISA法检测大鼠外周血中肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6及IL-10表达量;利用Western blotting法检测肝组织中Toll样受体4(TLR4)、磷酸化NF-κB抑制蛋白(p-IκB)、白细胞介素-1受体相关激酶4(IRAK-4)、磷酸化肿瘤坏死因子受体相关因子6(TRAF6)和核转录因子-κB(NF-κB)p65的蛋白表达水平;在光镜下对肝组织进行形态学观察。结果:肝组织病理学结果显示APD组肝组织损伤程度轻于SAP组而重于SHAM组;在外周血中,与SHAM组比较,APD组TNF-α、IL-6、IL-10的表达水平均明显升高(P<0.01);与SAP组比较,APD组TNF-α、TL-6的表达水平降低(P<0.01),IL-10表达水平明显升高(P<0.01)。在肝组织中,与SHAM组比较,APD组TLR4、p-IκB、IRAK-4、TRAF6和NF-κB p65蛋白表达水平均明显升高(P<0.01);与SAP组比较,APD组TLR4蛋白表达水平均明显降低(P<0.01)。结论:SAP合并肝损伤大鼠早期应用APD治疗可减轻肝细胞损伤,且APD抑制SAP大鼠肝损伤可能通过抑制TLR4/NF-κB信号通路表达来实现。Objective:To investigate the effect of abdominal paracentesis drainage(APD)against liver injury in rats with severe acute pancreatitis(SAP).Methods:Thirty SD rats were randomly divided into SAP untreated group(SAP group),SAP APD group(APD group)and sham operation group(SHAM group),with 10 rats in each group.Sodium taurocholate was used to induce SAP model,ELISA method was used to detect the expression of tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-10 in rat peripheral blood;Western blotting was used to detect protein expression levels of TLR4,p-IκB,IRAK-4,TRAF6 and NF-κB p65 in liver tissue;morphology of liver tissue under microscope was observed.Results:The liver histopathological results showed that the degree of liver tissue damage in the APD group was lighter than that of the SAP group and heavier than that of the SHAM group.In peripheral blood,compared with SHAM group,the expression levels of TNF-α,IL-6 and IL-10 in APD group were significantly increased(P<0.01);compared with SAP group,the expression levels of TNF-αand TL-6 in APD group decreased(P<0.01),and the expression level of IL-10 increased significantly(P<0.01).In liver tissue,compared with SHAM group,the expression levels of TLR4,p-IκB,IRAK-4,TRAF6 and NF-κB p65 protein in APD group increased significantly(P<0.01);compared with SAP group,the expressions level of TLR4,p-IκB,IRAK-4,TRAF6 and NF-κB p65 protein in APD group decreased significantly(P<0.01).Conclusions:Early application of APD in rats with SAP combined with liver injury can reduce liver cell damage,and APD inhibits liver damage in SAP rats may be achieved by inhibiting the expression of TLR4/NF-κB signaling pathway.

关 键 词：重症急性胰腺炎 肝损伤 腹腔穿刺引流 

分 类 号：R576[医药卫生—消化系统]