大鼠急性重症梗阻性黄疸减黄过程中TNF-α和IL-2的变化

Changes of TNF-α and IL-2 Expressions during Internal Biliary Drainage in Acute Severe Obstructive Jaundice of Rats

目的探讨大鼠急性重症梗阻性黄疸减黄过程中血清TNF-α和IL-2及肝损伤的相关性,术前减黄对于免疫功能恢复的意义。方法以结扎胆总管(LCD)建立阻黄模型(LCD组,n=10),在建立阻黄模型1周后松解胆总管(ID组,n=60),正常组不进行任何处理(n=10)。采用放射免疫法测定正常组、LCD组术后1周及ID组不同时间点TNF-α、IL-2的含量,同时自动生化分析仪检测ALT和胆红素含量。结果 LCD组血清TNF-α为(1 320.58±82.15)μg.L-1,IL-2为(45.12±12.65)μg.L-1,与正常组相比差异均有统计学意义(P<0.01);引流1周时ALT和胆红素分别为(7.25±1.16)U.L-1和(51.03±7.52)μmol.L-1,与LCD组比较差异有统计学意义(P<0.01),与正常组比较差异无统计学意义(P>0.01);TNF-α在引流2周时已恢复正常,IL-2在引流4周时已恢复正常,与正常组比较差异均无统计学意义(P>0.01);LCD组和引流组不同时间点的TNF-α与ALT呈正相关(r=0.762,P<0.01)。结论 TNF-α和IL-2参与了肝损伤,术前减黄治疗对于急性重症梗阻性黄疸免疫功能的恢复具有重要意义。

Objective To investigate the serum levels of TNF-α and IL-2 and their relationship to liver damage during internal biliary drainage in acute severe obstructive jaundice rat,and the importance of preoperative biliary drainage for the recovery of immune function.Methods The rat model was estabilished by ligating common bile duct（LCD,n=10） and created internal biliary drainage after the first operation a week（ID,n=60）,normal group received no disposal（n=10）.While normal group received no disposal,TNF-α and IL-2 levels in serum were detected with ELISA,Serum ALT and bilirubin level with automatic biochemistry analyzer in normal group,LCD group after the first operation 1 week,ID group differenct weeks.Results Serum TNF-α and IL-2 levels were（1320.58±82.15）μg·L-1 and（45.12±12.65）μg·L-1 in the rats of LCD group and after 1 week the levels were increased significantly compared with that in the normal group（P0.01）;By internal biliary drainage after a week.Serum ALT and bilirubin levels were（7.25±1.16）U·L-1 and（51.03±7.52）μmol·L-1 and decreased significantly compared with that in the LCD group（P0.01）,none variability compared with that in the normal group（P0.01）;The serum level of TNF-α became normal level after internal biliary drainage after 2 weeks,and IL-2 became normal level after internal biliary drainage after 4 weeks,none variability compared with that in the normal group（P0.01）.the serum levels of TNF-αand ALT were well correlated（r=0.762,P0.01）.Conclusion TNF-α and IL-2 play an important role in liver damage due to obstructive jaundice,internal biliary drainage for the recovery of immune function play an important role in acute severe obstructive jaundice before surgery.