“胆汁外引流”降低重症急性胰腺炎大鼠胰腺损伤的作用及机制研究

Mechanism research of pancreas injury reduction in rats with severe acute pancreatitis by ＂ biliary external drainage ＂

目的 探讨“胆汁外引流”阻断胰腺坏死的作用与机制.方法 18只健康雄性SD大鼠按数字表法随机分为假手术组（Sham组）、重症急性胰腺炎组（SAP组）和重症急性胰腺炎＋胆汁外引流组（BED组）,每组6只.造模24h后,采用Schmidt评分标准对胰腺进行病理评分;采用全自动生化分析仪检测血清淀粉酶、脂肪酶的含量;采用荧光定量RT-PCR方法检胰腺组织中血红素加氧酶-1、肿瘤坏死因子-α和白细胞介素-6 mRNA基因水平的表达;采用Western blot方法检测胰腺组织中血红素加氧酶-1、核转录因子-κB p65蛋白水平表达.结果 BED组胰腺组织病理学评分显著低于SAP组[（13.3±0.8）vs（14.8±0.3）]（P＜0.05）;并且血清淀粉酶、脂肪酶水平也较SAP组明显降低[（3.3±0.2）×103 IU/L vs（5.2±0.6）×103 IU/L];（1.3±0.2）×103 IU/L vs（4.2 ±0.5）×103 IU/L）] （P ＜0.05）;BED组大鼠胰腺内肿瘤坏死因子-α、白细胞介素-6以及核转录因子-κB p65蛋白表达均比SAP组降低[（16.41±5.20）vs（21.69±3.63）;（17.18 ±3.55）vs（22.69 ±2.27）;（3.76 ±0.58） vs（4.88 ±0.12）] （P ＜0.05）;但是BED组胰腺组织内血红素加氧酶-1表达显著高于SAP组[基因水平：（5.61±1.66）vs （4.44±1.83）;蛋白水平：（1.52 ±0.64）vs（1.05 ±0.56）] （P＜0.05）.结论 “胆汁外引流”可降低SAP大鼠胰腺损伤,其机制可能与血红素加氧酶-1高表达相关.

Objective To investigate whether ＂biliary external drainage＂ has protective effect on the pancreas in rats with severe acute pancreatitis and its mechanism.Methods Eighteen male SD rats were randomly divided into sham group （Sham）,severe acute pancreatitis （SAP） and severe acute pancreatitis ＋ biliary external drainage （BED） groups.24 hours later,the morphological changes of pancreas were scored by Schmidt criterion,serum amylase and lipase levels were measured automatic biochemical analyzer,messenger RNA expression of heme oxygenase-l,tumor necrosis factor-α and interleukin-6 was detected by RT-PCR method,and pancreatic heme oxygenase-1 and nuclear factor-κBp65 protein expression was detected by Western blot.Results The score in BED group were significantly lower than in SAP group [（13.3 ± 0.8） vs （14.8 ± 0.3）] （P ＜ 0.05） ; The amylase and lipase in BED group were also reduced than those in SAP group [（3.3 ±0.2） × 103 IU/L vs（5.2 ±0.6） × 103 IU/L] ; （1.3 ± 0.2） × 103 IU/L vs（4.2 ±0.5） × 103 IU/L）] （P ＜ 0.05） ;The expression levels of tumor necrosis factor-α,interleukin-6 and NF-κB p65 were significantly decreased than in SAP group[（16.41 ± 5.20）vs （21.69 ± 3.63）;（17.18 ± 3.55） vs （22.69 ± 2.27） ; （3.76 ± 0.58） vs （4.88 ± 0.12）] （P ＜ 0.05） ; But the expression of HO-1 after ＂biliary external drainage＂ was significantly elevated when compared to the SAP [mRNA：（5.61 ± 1.66）vs （4.44 ± 1.83） ;protein：（1.52 ±0.64）vs（1.05 ±0.56）] （P ＜0.05）.Conclusions ＂Biliary external drainage＂ can reduce injury of the pancreas in rats with SAP,which may be closely related to the HO-1 expression.