伴高脂血症急性坏死性胰腺炎大鼠胃肠传输与肠肌间神经丛形态改变研究

The study on gastrointestinal transit and changes of myenteric nerve plexus in acute necrotic pancreatitis rats complicated with hyperlipemia

目的探讨肠肌间神经丛形态改变与伴高脂血症急性坏死性胰腺炎（ANP）大鼠胃肠传输延迟的关系。方法将40只雄性SD大鼠均分为4组（正常对照组、单纯ANP组、高脂对照组、高脂ANP组），分组采用高脂饲料喂养4周建立大鼠高脂血症模型，应用逆行胰胆管注射3．5％牛磺胆酸钠制作ANP大鼠模型。用墨汁灌胃法测量各组大鼠胃肠传输距离，计算胃肠传输率，以Karnovsky-Root直接法和NADPH组织化学法观察回肠肌间神经丛胆碱能和氮能神经的组织形态学改变。结果高脂ANP组较单纯ANP组胰腺炎病理损伤加重（病理学评分12．8±0．63比10．8±1．93，P〈0．01），胃肠传输明显延迟（传输率27％±5％比38％±6％，P〈0．01），胆碱能神经元密度下降（4．80±1．23比5．80±0．79，P％0．05），氮能神经元密度明显升高（8．70±0．75比6．80±1．48，P〈O．01）。肌间神经丛乙酰胆碱脂酶和一氧化氮合酶改变与胃肠传输率有线性回归关系（R^2=0．531，P〈0．01）。结论伴高脂血症ANP的大鼠存在明显胃肠动力障碍，肠肌间神经丛形态改变与其密切相关。

Objective To explore association between the changes of myenteric nerve plexus and the delayed gastrointestinal transit in acute necrotic pancreatitis （ANP） rat complicated with hyperlipemia. Methods Atotal of 40 male Sprague Dawley （SD） rats were randomly divided into 4 groups （normal control group, ANP group, hyperlipemia （HL） control group and HL with ANP group）. HL rat model was established by fed with high-fat diet for 4 weeks, and ANP rat model was induced by retrograde injection of 3.5% sodium taurocholate into pancreatic duct. Gastrointestinal transit distance was measured by ink gavage method. The histological changes of cholinergic and nitriergic nerves in myenteric plexus were observed by Karnovsky-Root method and NADPH histochemistry method. Results Pathological injuries were more severe in HL with ANP group than in ANP group （12.8±0.63 vs. 10.8±1.93,P〈0.01）, gastrointestinal transit was obviously delayed （transmission rate was 27%±5% vs. 38% ±6%,P〈0.01）, the density of cholinergic neurons decreased （4.80±1.23 vs. 5.80±0.79, P〈0.05）, and the density of nitriergic neurons significantly increased （8. 70±0.75 vs. 6.80±1. 48, P〈0.01）. There was a linear regression between changes of cholinergic and nitrievgic nerves in myenteric nerve plexus and gastrointestinal transit （R^2 = 0. 531,P%O, 01）. Conclusion There was significant gastrointestinal motility disorder in the ANP rat complicated with hyperlipemia, which may he closely related with the changes of myenterie nerve plexus.