S-腺苷甲硫氨酸对大鼠重症急性胰腺炎的保护作用

Protective effect of S-adenosylmethionine against pancreas injury in rats with severe acute pancreatitis

目的:探讨S-腺苷甲硫氨酸(SAM)对大鼠重症急性胰腺炎(SAP)的保护作用及机制。方法:采用5%牛磺胆酸钠逆行胰胆管注射制备SAP大鼠模型,将雄性SD大鼠40只,随机分为4组,假手术组(SO组)、急性胰腺炎组(SAP组)、SAM低剂量治疗组(LSAM组)、SAM高剂量治疗组(HSAM组),每组10只。LSAM组和HSAM组大鼠造模前2 h分别腹腔内注射100mg/kg及200mg/kg SAM,其余各组注射等量生理盐水。造模后6h开腹下腔静脉取血,采用全自动生化分析仪检测各组血清淀粉酶水平,酶联免疫吸附法(ELISA)检测血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的浓度;取大鼠胰腺组织送病理检查,常规HE染色,胰腺病理组织评分采用Schmidt法。结果:与SO组比较,SAP组、LSAM组和HSAM组胰腺病理组织评分及血清淀粉酶、TNF-αI、L-6水平均升高(P<0.01);干预性使用SAM后,胰腺病理组织评分及血清淀粉酶、TNF-αI、L-6水平均较SAP组降低(P<0.01)。HSAM组血清淀粉酶、TNF-α水平低于LSAM组(P<0.05),胰腺组织病理评分及血清IL-6水平与LSAM组比较差异无统计学意义。结论:外源性补充SAM能降低炎性因子的表达,对重症急性胰腺炎具有保护作用。

Objective： To study the protective effects of S-adenosylmethionine against pancreas injury in rats with severe acute pancreatitis（SAP） and explore its underlying mechanisms.Methods： The SAP model was induced by retrograde infusion of 5% sodium taurocholate into the biliopancreatic duct.Fourty male Sprague-Dawley rats were randomly assigned into 4 groups： sham-operated group（SO group,n=10）,severe acute pancreatitis group（SAP group,n=10）,low dose SAM treated group（LSAW group,n=10） and high dose SAM treated group（HSAW group,n=10）.At 2 hours before the operation,the SO group and the SAP group were injected intraperitoneally 0.9% saline,the LSAM group and the HSAM group were injected intraperitoneally 100mg/kg and 200mg/kg SAM respectively before induction of SAP.All rats were sacrificed at 6 hours after operation to collect blood and pancreas samples.Serum activities of amylase were measured,the concentrations of tumor necrosis factor（TNF）-α,interleukin（IL）-6 in serum were measured by ELISA and pancreatic histologic score were assessed.Results： Compared with SO group,pancreatic histologic score,serum amylase,tumor necrosis factor（TNF）-α,interleukin（IL）-6 levels in SAP group were significantly increased（P0.01）.Pretreatment with SAM obviously decreased pancreatic histologic score and serum amylase,TNF-α and IL-6 levels（P0.01）.Serum amylase and TNF-α level in HSAM group were lower than those in LSAM group（P0.05）.Pancreatic histologic score and serum interleukin（IL）-6 level were no significantly differences in the LSAM group and the HSAM group.Conclusion： Exogenous supplement SAM can significantly decrease serum inflammatory cytokines levels and play an important role in protectiving against pancreas injury in rats with severe acute pancreatitis.