髓系细胞触发受体-1对重症急性胰腺炎大鼠肠屏障功能的影响

The effects of triggering receptor - 1 present on myeloid cellsn on intestinal barrier dysfunction with severe acute pancreatitis

目的探讨髓系细胞触发受体-1（triggering receptor-1 on myeloid cells，TREM-1）的表达与重症急性胰腺炎（severe acute pancreatitis，SAP）肠屏障功能障碍的关系。方法雄性Wistar大鼠64只，随机（随机数字法）分为假手术组（SO）和SAP组，每组32只，采用逆行胰胆管注射5％牛磺胆酸钠制备SAP大鼠模型，分别于造模后2，6，12，24h时点取血和回肠组织。改良分光光度法检测血浆D-乳酸、二胺氧化酶（diamine oxidase，DAO）和内毒素浓度。逆转录-聚合酶链反应（RT—PCR）方法检测回肠组织TREM-1、白细胞介素-1β（interleukin-1β，IL-1β）和肿瘤坏死因子-α（tumor necrosis factor—α，TNF—α）mRNA的表达水平。对数据进行单因素方差分析和spearman相关性分析，P〈0．05表示差异具有统计学意义。结果SAP组各时点血浆D一乳酸、DAO和内毒素的水平均高于假手术组（P〈0．01，P〈0．05）；SAP组各时点回肠组织TREM-1，IL-1β和TNF-α mRNA的表达水平较假手术组显著增高（P〈0．01，P〈0．05），TREM-1 mRNA表达水平与IL-1β及TNF—α mRNA表达水平均呈正相关（r=0．956，P=0．044；r=0．986，P=0．015），IL-1β mRNA表达水平与TNF—α mRNA表达水平无明显相关性（P=0．133）。结论SAP时，大鼠肠组织内TREM-1表达上调，促进炎症介质释放和肠黏膜损伤加重，TREM-1在SAP肠屏障功能障碍的发生发展中起重要作用。

Objective To investigate the relationship between the expression of triggering receptor - 1 present on myeloid cells （ TREM - 1 ） in intestinal tissue and intestinal barrier dysfunction in severe acute pancreatitis （SAP）. Methods Sixty - four male Wistar rats were randomly （ random number） divided into sham operation group （ SO group, n = 32） and SAP group （ n = 32）. The SAP model was established by retrograde injection of 5% sodium deoxycholate into bile -pancreatic duct. Specimens from blood and intestinal tissue were collected 2, 6, 12 and 48 hours after modeling. The levels of D - lactate, diamine oxidase （DAO） and endotoxin in serum were measured with an modified spectro - photometric method. The expressions of TREM - 1, IL - 1 β and TNF -α mRNA in terminal ileum were detected by RT - PCR. All data were processed with SPSS version 16. 0 package to make one - way ANOVA and Spearman correlation analysis. Results The serum levels of D - lactate, DAO and endotoxin were significantly increased at all intervals in SAP group compared with SO group （ P 〈 0. 05 ）. The expressions of TREM - 1, IL - 1 βand TNF -α mRNA in terminal ileum of rats in SAP group at all intervals were significantly higher than those in SO group （P 〈 0. 05 ）. The expression of TREM - 1 mRNA was positively correlated with expressions of IL - 1β and TNF - αmRNA （r =0. 956, P =0. 044; r =0. 986, P =0. 015）, but correlation was not found between expressions of IL - 1β mRNA and TNF -α mRNA （P = 0. 133 ）. Conclusions The expression of TREM - lmRNA in intestinal tissue of rats with SAP is elevated, leading to the release of inflammatory cytokines and intestinal mucosal injury, indicating TREM - 1 might play an important role in the genesis of intestinal barrier dysfunction in rats with SAP.