清胰汤联合骨髓间充质干细胞对重症急性胰腺炎肺损伤气血屏障的保护作用  

The protective effect of Qingyi decoction combined with bone marrow mesenchymal stem cells on the air-blood barrier in severe acute pancreatitis with lung injury

作　　者：刘晓君 白卜月 武平[1] 陈海龙[3] 闻庆平[1] LIU Xiao-jun;BAI Bu-yue;WU Ping(Department of Anesthesiology,The First Affiliated Hospital of Dalian Medical University,Dalian 116000,China)

机构地区：[1]大连医科大学附属第一医院,大连116000 [2]大连市第三人民医院,大连116000 [3]大连医科大学中西医结合研究院,大连116000

出　　处：《中国中西医结合外科杂志》2025年第1期105-110,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金(82474277);国家重点研发计划(2019YFE0119300);辽宁省重点实验室项目(LJKZ0851)。

摘　　要：目的:探讨清胰汤联合骨髓间充质干细胞(BMSCs)对重症急性胰腺炎肺损伤(SAPALI)肺气血屏障的保护作用。方法:用3.5%牛磺胆酸钠逆行注射大鼠胆胰管建立SAPALI模型。将50只雄性大鼠均分为假手术组、模型组、清胰汤组、BMSCs组及清胰汤联合BMSCs组。HE染色检测胰腺和肺组织损伤。ELISA法检测大鼠血清脂肪酶、肿瘤坏死因子(TNF)-α和白细胞介素(IL)-6表达水平。免疫组化检测肺氧化应激相关指标髓过氧化物酶(MPO)和4-羟基壬烯酸(4-HNE)水平变化。使用免疫荧光分析和Western Blotting检测肺泡上皮细胞和肺微血管内皮细胞的表达水平。结果:清胰汤能显著改善重症急性胰腺炎(SAP)引起的肺微环境损伤。与BMSCs组相比,联合使用BMSCs可下调TNF-α、IL-6在肺泡灌洗液中的表达以及肺组织中MPO和4-HNE的表达,提示清胰汤能够促进BMSCs修复肺气血屏障。清胰汤和BMSCs联合治疗增加了SAPALI大鼠肺泡上皮细胞和肺微血管内皮细胞的表达。结论:清胰汤联合BMSCs可通过降低炎症反应和氧化应激水平来促进SAPALI肺气血屏障的修复。Objective To explore the protective effect of Qingyi decoction combined with bone marrow mesenchymal stem cells(BMSCs) on the lung air-blood barrier in severe acute pancreatitis lung injury(SAPALI).Methods The SAPALI model was established by retrograde injection of 3.5% sodium taurocholate into the bile and pancreatic ducts of rats.Fifty male rats were evenly divided into sham operation group,model group,Qingyi decoction group,BMSCs group and Qingyi decoction combined with BMSCs group.HE staining detects pancreatic and lung tissue damage.ELISA was used to detect the expression levels of serum lipase,TNF-α and IL-6.Immunohistochemistry was used to detect changes in levels of lung oxidative stress-related indicators myeloperoxidase(MPO) and 4-hydroxynonenoic acid(4-HNE).Immunofluorescence analysis and Western Blotting were used to detect the expression levels of alveolar epithelial cells and microvascular endothelial cells.Results Qingyi decoction can significantly improve the pulmonary microenvironment caused by severe acute pancreatitis.Compared with the BMSCs group,combined use of BMSCs can down-regulate the expression of TNF-α and IL-6 in bronchoalveolar lavage fluid as well as the expression of MPO and 4-HNE in lung tissue.The above results suggest that Qingyi decoction can promote BMSCs to repair the lung air-blood barrier.Combined treatment with Qingyi decoction and BMSCs increased the expression of alveolar epithelial cells and pulmonary microvascular endothelial cells in SAPALI.Conclusion Qingyi decoction combined with BMSCs can promote the repair of lung air-blood barrier in SAPALI by reducing the level of inflammatory response and oxidative stress.

关 键 词：急性肺损伤 清胰汤 骨髓间充质干细胞 气血屏障 重症急性胰腺炎 

分 类 号：R657.51[医药卫生—外科学] R563.1[医药卫生—临床医学]