尿激酶对大鼠重症急性胰腺炎肠道微循环障碍的作用

Effect of urokinase on intestinal microcirculatory dysfunction in rats with severe acute pancreatitis

目的:观察重症急性胰腺炎(SAP)时肠道微循环血流量和白细胞介素1β(IL-1β)的变化以及尿激酶的作用。方法:雄性Wistar大鼠192只,随机分成对照组、SAP组和治疗组。以5%牛磺胆酸钠胰腺逆行胰胆管注射复制SAP模型,治疗组经颈静脉注射尿激酶。采用放射生物微球技术在制模后2,6,12,24h分别测定肠组织微循环血流量,同时检测血清IL-1β水平,并观察肠黏膜病理改变。结果:SAP组在制模后各时段肠组织血流量较对照组明显减少(P<0.01),血清IL-1β活性较对照组明显升高(P<0.01),肠黏膜损伤程度较对照组明显加重(P<0.01);治疗组2,6,12h肠组织血流量与SAP组比较升高(P<0.01),24h变化不明显,血清IL-1β活性各时段与SAP组比较减少(P<0.01),肠黏膜损伤程度较SAP组明显改善(P<0.01)。结论:SAP时肠组织血流量减少同时伴有炎性介质IL-1β的升高,尿激酶能改善微循环,减轻肠道损伤。

Objective：To explore the effect of urokinase on intestinal microcirculatory blood flow and interleukin-1β （IL-1β） in rats with severe acute pancreatitis （SAP）. nethods：A total of 192 male Wistar rats were randomly divided into control group,SAP group,and treatment group. The rat model of SAP was established by intravenous injection of 5% sodium taurocholate into the pancreaticobiliary duct. The rats in treatment group were injected with urokinase via the cervical vein. Radioactive biomicrosphere technique was performed to measure the intestinal blood flow after 2,6,12, and 24 hours. The level of IL-1β was detected by radioimmunoassay, and the pathological changes in intestinal mucosa were observed. Results：Compared with control group,in SAP group,the intestinal blood flow significantly decreased （P 〈 0.01 ） at each time point;the level of IL-1β significantly increased at each time point （P 〈 0.01 ）;and the intestinal mucosal injury was more severe （P 〈 0.01）. Compared with SAP group,in treatment group,the intestines blood flow significant increased at 2,6,and 12 hours （P 〈 0.01 ）,but the increase was not significant at 24 hours ;the level of IL-1β significantly decreased at each time point （P 〈 0.01 ）;and the pathological changes in intestinal mucosa was significantly improved （P 〈 0.01 ）. Conclusion：In SAP rats,the intestinal blood flow decreases and the level of IL-1β increases. Urokinase could improve intestinal microcirculation and alleviate intestinal injuries in SAP rats.