重症急性胰腺炎腹水内磷脂酶A_2对腹膜通透性的影响

THE EFFECT OF PLA_2 IN ASCITES ON THE CHANGE OF PERITONEAL PERMEABILITY IN SEVERE ACUTE PANCREATITIS

目的 应用SD大鼠重症胰腺炎模型探讨磷脂酶A_2是否与腹膜通透性升高有关.方法40只大鼠分为4组,分别于制模后3、6.12h和自然死亡时取材,测定腹水体积和腹水内粒细胞弹力蛋白酶(PMNE)及PLA_2的活性,观测前两者分别与磷脂酶A_2活性的关系,同时观察胰腺组织的病理学改变.结果 随病情加重,磷脂酶A_2的活性与腹水体积呈显著升高趋势,两者之间的相关系数是0.94,并且任何两组间的腹水体积皆有显著差异.PMNE的活性,在3～12h内呈显著下降,而死亡组的活性反而升高.3～12h内,PMNE活性与磷脂酶A_2活性的相关系数是-0.87.结论 腹水内PLA_2是导致重症急性胰腺炎腹膜通透性升高的关键因素,且呈剂量依赖性.

Objective: Using acute pancreatitis model in SD rats to investigate whether PLA2 is related to peritoneal permeability or not. Methods : Forty rats were divided into 3hr group(Ⅰ) ;6hr group (Ⅱ); I2hr group(Ⅲ) and natural dead group(Ⅳ). At the four time points, volume of ascites, activity of PMNE in ascites and activity of PLA2 in ascites were determined. The correlation of volume of ascites and activity of PMNE with activity of PLA2 were observed. At the same time, pathological changes of pancreata were observed. Results : With the progressed lesions of pancreata, the activity of PLA2 in as-Cites and ascitic volume were increased significantly (P < 0.05); and there was positive correlation between them( r = 0.94). The volume of ascites was significantly different between any two groups. The activity of PMNE in ascites was significantly decreased from 3hr to 12hr, however, it was increased significantly in natural dead group. The acitvity of PLA2 in ascites was correlated with the activity of PMNE inversely(r= - 0.87). Conclusion: PLA2 in ascites play a major role in the change of peritoneal permeability in SAP, and the permeability was correlated with dosage positively.