醛固酮与依普利酮在自发性高血压大鼠胰腺损伤中的作用

Effects of aldosterone and eplerenone on pancreatic lesion in rats with spontaneous hypertension

目的观察醛固酮与依普利酮在自发性高血压大鼠（SHR）胰腺损伤中的作用。方法将SHR分为依普利酮治疗组及未治疗组，WKY大鼠作为对照，分别检测血清葡萄糖、胰岛素和钾离子，血浆及胰腺组织醛固酮水平，胰腺病理标本行masson染色及TUNEL＋胰岛素免疫组化双重染色。结果治疗组和未治疗组血糖均高于对照组（P〈0．05），治疗组与未治疗组无差异；未治疗组血胰岛素高于治疗组和对照组（14．38±2．68VS11．42±2．02与11．23±2．42μIU／ml，P〈0．01），治疗组与对照组无差异；未治疗组HOMA—IR高于对照组（4．16±0．99VS2．94±0．75，P〈0．01）和治疗组（3．28±0．61，P〈0．05），治疗组与对照组无差异；治疗组血醛固酮高于未治疗组和对照组（799．84±67．30VS554．56±89．26和480．40±90．21pg／ml，P〈0．01），未治疗组高于对照组（P〈0．05）；治疗组胰腺醛同酮高于未治疗组（135．77±34．34VS90．29±15．53pg／ml，P〈0．05）和对照组（75．28±10．82pg／ml，P〈0．01），未治疗组高于对照组（P〈0．05）；未治疗组胰岛纤维化面积比和胰岛β细胞凋亡指数高于治疗组和对照组（P〈0．01），治疗组高于对照组（P〈0．01）。结论26周龄SHR存在胰腺损伤；胰腺醛固酮在胰岛β细胞凋亡和纤维化中发挥重要促进作用；依普利酮可改善SHR胰岛素抵抗，抑制胰腺纤维化，降低胰岛β细胞凋亡指数，对SHR大鼠胰腺损伤具有保护作用。

Objective To observe the effects of aldosterone and cplerenone on pancreatic lesion in rats with spontaneous hypertension. Methods The rats with spontaneous hypertension were divided into the treatment group （treated with eplerenone） and non-treatment group, and WKY rats were included into the control group. The levels of serum glucose, insulin and potassium ion, and plasma and pancreatic aldosterone were detected respectively. The pathological sample of pancreas was stained by masson staining and TUNEL ＋ insulin immunohistochemstry staining. Results The level of serum glucose in the treatment group and non-treatment group was higher than that in the control group （ P 〈 0.05 ） , and there was no difference between the treatment group and non-treatment group. The level of serum insulin （μIU/mL） in the non-treatment group was higher than that in the treatment group and control group （ 14.38 ± 2.68 vs 11.42 ±2.02 and 11.23± 2.42 ,P 〈 0.01 ） , and there was no difference between the treatment group and control group. The HOMA-insulin resistance index （HOMA-IR） in the non-treatment group was higher than that in the control group （4.16 ±0.99 vs 2.94±0.75,P 〈0.01） and that in the treatment group （3.28 ±0.61 ,P 〈 0.05 ） , and there was no difference between the treatment group and control group. The level of plasma aldosterone （pg/mL） in the treatment group was higher than that in the non-treatment group and control group （799.84 ± 67.30 vs 554.56 ±89.26 and 480.40±90.21,P 〈 0.01 ）, and that in the non-treatment group was higher than that in the control group （P 〈 0.05）. The level of pancreatic aldosterone （pg/mL） in the treatment group was higher than that in the non-treatment group （ 135.77 ±34.34 vs 90.29 ± 15.53, P 〈 0.05 ） and that in the control group （ 75.28± 10.82, P 〈 0.01 ）, and that in the non-treatment group was higher than that in the control group （ P 〈 0.05）. The area of islet fibrosis and apoptosis index （AI） of islet β-cells in the non-treatment group were higher than those in the treatment group and control group （ P 〈 0.01 ）, and those in the treatment group were higher than those in the control group （P 〈 0.01 ）. Conclusion The rat aged 26 weeks with spontaneous hypertension has pancreatic lesion. Aldosterone plays an important role in the development of the apoptosis of islet β-cells and islet fibrosis. Eplerenone can relieve insulin resistance, inhibit islet fibrosis, decrease the apoptosis index of islet β-cells and protect the pancreas from lesion in rats with spontaneous hypertension.