双利肝和甘氨酸对重症急性胰腺炎大鼠Th1/Th2平衡的影响

Effects of Shuangligan and Glycine on Th1/Th2 balancing in rats with severe acute pancreatitis

目的 探讨双利肝和甘氨酸对重症急性胰腺炎（SAP）大鼠,Th1/Th2平衡的影响.方法 Wistar大鼠32只,随机选择24只术前禁食12 h,不禁水,1%戊巴比妥钠腹腔注射麻醉,取上腹部正中切口入腹腔,于胆胰管远端逆行推注5%牛磺胆酸钠溶液0.1 ml/100 g,制造SAP模型.假手术组8只以等量生理盐水代替5%牛磺胆酸钠溶液.24只SAP大鼠中选择8只在造模后0.5 h从尾静脉注射0.2%大黄酸4 mg/kg和0.4%丹参素8 mg/kg（双利肝组）,8只在造模后0.5 h从尾静脉注射20%甘氨酸0.6 g/kg（甘氨酸组）,余8只为单纯SAP组.32只大鼠分别于造模后24 h采集腹主动脉血,观察造模后24 h血浆内毒素和血清淀粉酶的变化及双利肝和甘氨酸对Th1/Th2比值的影响.结果 单纯SAP组血浆内毒素[（0.67±0.11）EU/ml]、促炎细胞因子[干扰素-γ（8.43±0.86）ng/L,白细胞介素-12（8.26±1.97）ng/L]和Th1/Th2比值（0.36±0.07）明显高于假手术组[内毒素（0.44±O.07）EU/ml,干扰素-γ（3.80±0.55）ng/L,白细胞介素-12（3.34±1.34）ng/L,Th1/Th2比值（0.24±0.05）,P均〈0.05];与单纯SAP组相比,双利肝和甘氨酸均显著降低血浆内毒素[（0.57±0.08）、（0.52±0.04）EU/ml,P均〈0.05],使Th1/Th2比值[双利肝组：0.29±0.04,甘氨酸组：0.25±0.06;P均〈0.05]趋于平衡.结论 在SAP的早期,血浆内毒素的升高使机体的细胞免疫功能过强,导致组织细胞损伤加重;而双利肝和甘氨酸都能抑制肠源性内毒素血症的形成,减轻或阻止了组织细胞的损伤.

Objective To investigate the effects of Shuangligan and Glycine on Thl/Th2 balancing on severe acute pancreatitis （ SAP） in rats. Methods Thirty-two Wistar rats weighing （260 ± 20） g were randomly divided into sham operation （SO） group, SAP group, SAP ＋ Slg （with the treatment by Shuangligan） group and SAP ＋ Gly （with the treatment by Glycine ） group. Each group included 8 rats, which accepted different treatment according to the experimental design. Changes of plasma level of endotoxin （ ET） and serum amylase （AMY） and the effects of Shuangligan and Glycine on Thl/Th2 ratio at the 24th hour after operation were observed respectively. Results The plasma endotoxin （ET） level （ （0. 67 ±0. 11） EU/ml）,proinflammatory cytokine （INF-γ：（8.43 ± 0.86） ng/L, IL-12： （8.26 ± 1.97） ng/L） and Thl/Th2 ratio （0.36 ± 0.07） in SAP group were significantly higher than those in SO group（ ET： （0. 44 ±0.07） EU/ml, INF-γ： （3. 80 ±0. 55） ng/L, IL-12： （3. 34 ± 1. 34）ng/L,Thl/Th2 ratio （0. 24 ±0. 05） ） （P 〈0. 05）. Compared with SAP group, SAP ＋ Slg and SAP ＋ Gly group had remarkably decreased plasma ET level （ （0. 57 ± 0. 08,0. 52 ± 0. 04） EU/ml） （P 〈 0. 05） and the Thl/Th2 ratio reached equilibrium （ SAP ＋ Slg group; （0. 29 ± 0. 04 ）, SAP ＋ Gly group： （0. 25 ± 0. 06 ）） . Conclusions In the earlier stage of SAP, the rising plasma ET level may cause the overreaction of the cell mediated immune response, which leads to the aggravated damages in tissue cells. Our data indicates that Shuangligan and Glycine can restrain the formation of intestinal endotoxemia and alleviate or prevent the tissue injuries.