细胞因子在重症急性胰腺炎相关性腹水致急性肺损伤中的作用机制研究

目的:探讨细胞因子在重症急性胰腺炎相关性腹水致急性肺损伤中的表达及意义。方法:成年wistar大鼠45只,随机分为3组:①阴性对照组(C组):开腹后仅翻动胰腺组织;②重症急性胰腺炎组(S组):3.5%牛磺胆酸钠胰胆管逆行注射制造重症急性胰腺炎模型;③腹腔注射组(E组):取S组大鼠胰腺匀浆及腹水,于正常大鼠腹腔内注射。于造模后3、6、12小时分批处死大鼠,取胰腺及肺组织行病理检查。以PCR法检测肺组织NF-κBmRNA的表达,免疫组化法检测TNF-α、IL-1β的表达。结果:S组及E组肺泡间质水肿、出血,并有中性粒细胞、巨噬细胞浸润。在不同时间点,S组和E组肺组织NF-κB、TNF-α、IL-1β表达均高于C组(P<0.01)。结论:重症急性胰腺炎相关性腹水可以导致急性肺损伤,肺组织中NF-κB、TNF-а、IL-1β表达升高,提示其参与了急性肺损伤的发生过程,其原因可能与相关性腹水激活了粒细胞有关。

Object：To investigate the expression and significance of cytokines in acute lungs injury of severe acute pancreatitis associated ascetic fluid.Methods：Forty-five adult wistar rats were randomly assigned into the group of negative control （group C,n=15）,the group of severe acute pancreatitis （group S,n=15） and the group of peritoneal injection （group E,n=15）.The group C was cut peritoneum and flipped pancreases softly.In group S,3.5% sodium taurocholate was injected retrograde in pancreatic and bile duct to establish the model of severe acute pancreatitis,and the pancreatic homogenate and ascites of the group S was injected into abdominal cavity of group E rats.After animal model established,rats were killed at 3h,6h and 12h point.Pancreas and lungs was cut for detection of pathology and the expression of nuclear factor-κB（NF-κB）,tumor necrosis factor-α（TNF-α）and interleukin-1β（IL-1β）.Results：Interstitial edema,hemorrhage and infiltration of neutrophilic granulocyte and macrophage were observed in group S and E.At different time point,the expression of NF-κB,TNF-α,and IL-1β of lungs in group S and E were significantly higher than that of group C （P〈0.01）.Conclusions：Acute lungs injury can be induced by the severe acute pancreatitis associated ascetic fluid.The expression of NF-κB,TNF-α,and IL-1β of lungs was increased to induce acute lungs injury,the reason may be concerned with activation of granulocyte by severe acute pancreatitis associated ascetic fluid.