血小板活化因子乙酰水解酶对重症急性胰腺炎影响的实验研究

Experimental study of the effect of platelet-activating factor acetylhydrolase on severe acute pancreatitis

目的探讨血小板活化因子乙酰水解酶(PAF-AH)对重症急性胰腺炎(SAP)的影响。方法4 5只雄性W istar大鼠随机分为3组(每组n=1 5):A组(sham组),B组(SAP组),C组(PAF-AH干预组)。C组于造模1 h和2 4 h后经阴茎背动脉注射PAF-AH(5mg/kg)。各组均于术后4 8 h测定血丙二醛(MDA),血栓素(TXB2),前列腺素(PGI2),TXB2/PGI2,血小板活化因子(PAF),内毒素,肿瘤坏死因子α(TNF-α)含量及肺组织髓过氧化物酶(MPO)活性;对胰腺进行病理学评分。结果与B组相比,C组血MDA,TXB2,TXB2/PGI2,PAF,内毒素,TNF-α含量及肺组织MPO活性、胰腺病理学评分显著降低(P<0.0 5);血PGI2含量无显著差异(P>0.0 5)。结论PAF在SAP病程演进中起关键的作用。应用PAF-AH能够水解PAF、改善胰腺微循环障碍、抑制系统炎症反应、减轻肠道及肺损伤,显著改善SAP病情。

Objective To investigate the effect of platelet-activating factor acetylhydrolase （PAF-AH） on severe acute pancreatitis （ SAP ）. Methods Forty-five male Wistar rats were randomly divided into three groups （ n = 15 in each group ） , including group A （ sham operation group ） , group B （ SAP group ） and group C （PAF-AH treated group ）, PAF-AH （5 mg/kg ） was infused through the dorsal artery of penis after 1 hour and 24 hours of establishing the model in group C. Forty-eight hours after animal models were established , the levels of maleic dialdehyde （ MDA ） , thromboxane B2 （ TXB2 ） , prostaglandin I2 （ PGI2 ） , TXB2/PGI2 , platelet-activating factor （ PAF ） , endotoxin, tumor necrosis factor （ TNF-α） in serum , and the activity of myeloperoxidase （ MPO ） in lung tissue were examined in each group, The pancreas was scored on the basis of pathological changes, Results Compared with group B, the levels of MDA, TXB2 , TXB2/PGI2 , PAF, endotoxin, TNF-α in serum, and MPO activity in lung tissue and the pathological scores of pancreas were significantly lower in group C （ P 〈 0.05 ） , There was no obvious difference in the level of PGI2 between group B and group C （ P 〉 0. 05 ） . Conclusions PAF plays a critical role during the course of SAP, Administration of PAF-AH can hydrolyze PAF, improve pancreatic microcirculatory dysfunction, suppress systemic inflammatory reaction, relieve pancreatitis-associated intestinal tract injury and lung injury and markedly ameliorate the state of SAP,