维生素C和E在高脂血症急性胰腺炎中的作用

Effect of Vitamin C and Vitamin E on acute hyperlipidemia pancreatitis

目的观察维生素C(Vit C)、维生素E(Vit E)在干预高脂血症急性胰腺炎(HLP)的脂质代谢及炎症介质释放的作用并探讨其影响机制。方法 110只SD健康雄性大鼠随机分为两组,正常组(n=10)均衡饲料饲养2周,心脏取血测定TG水平。其余100只SD大鼠均衡饲料饲养+30%脂肪乳剂灌胃2周后随机分为五组:假手术组、HLP+0.9%氯化钠注射液组(HLP组)、HLP+Vit C组(Vit C组)、HLP+Vit E(Vit E组)、HLP+Vit C+Vit E组(联合组),每组20只(n=20)。各组术后6 h、24 h分批各处死10只大鼠,心脏取血,分离、检测血清淀粉酶(AMY)、甘油三酯(TG)、脂肪酶(LPS)、超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6),并切取胰腺进行病理学评分。结果与正常组血清TG水平相比,其余五组SD大鼠TG水平都明显升高(t分别=-3.36、-6.17、-3.38、-0.16、-2.57、-3.18、-4.70、-3.22、-4.01、-3.00,P均<0.05)。Vit C组、Vit E组和联合组在两时间点血清TG含量与HLP组差异无统计学意义(t分别=0.66、0.32、0.53、0.20、0.05、0.14,P均>0.05)。血清AMY及LPS的变化:Vit C组、Vit E组和联合组较HLP组两时间点血清AMY及LPS含量明显下降(t分别=2.40、2.46、3.13、4.61、3.60、5.59、1.01、2.10、4.95、2.18、3.40、5.92,P均<0.05)。联合组与Vit C组、Vit E组比较差异有统计学意义(t分别=-2.78、-2.37、-3.06、-5.74、-4.27、-3.23、-4.00、-2.25,P均<0.05)。细胞因子TNF-α、IL-6的检查:Vit C组、Vit E组和联合组较HLP组两时间点血清TNF-α、IL-6含量明显下降(t分别=11.27、11.12、22.82、10.29、10.16、19.32、3.13、2.55、5.35、2.34、1.73、5.27,P均<0.05)。联合组与Vit C组、Vit E组比较差异有统计学意义(t分别=-11.61、-9.02、-10.50、-9.46、-2.49、-2.95、-2.54、-3.56,P均<0.05)。抗氧化水平的SOD检测:Vit C组、Vit E组和联合组的血清SOD水平较HLP组均明显增高(t分别=5.22、4.96、8.15、4.45、5.59、9.53,P均<0.05)。联合组与Vit C组、Vit E组比较差异有统计学意义(t分别=4.09、3.14、4.29、2.79,P均<0.05)。HLP组、Vit C组、Vit E组和联合组与假手术组相比,胰腺病理评分差异有统计学意义(t分别=-19.00、-15.00、-9.03、-11.00、-16.87、-18.00、-17.00、-11.00,P均<0.05)。与HLP组相比,Vit C组、Vit E组和联合组的胰腺病理评分差异有统计学意义(t分别=2.98、2.16、5.96、2.52、3.16、5.69,P均<0.05)。而联合组的病理评分较Vit C组、Vit E组分值低,差异有统计学意义(t分别=-2.98、-2.16、-3.72、-2.98,P均<0.05)。结论 Vit C和Vit E在HLP中也具有明确的抗氧化作用,联合应用的抗氧化作用更为明显。

Objective To investigate the effect of Vitamin C and Vitamin E on intervening lipid metabolism and the re-lease of inflammatory mediators in patients with acute hyperlipidemia pancreatitis（HLP） and explore their action mechanism. Methods A total of 110 male SD rats were randomly divided into two groups. The control group was feeded with balance fodder for two weeks, and then drawing blood from heart to detect TG level. Other 100 male SD rats received intragastric administration of 30% fat emulsion 2 weeks based on balance fodder, and then were randomly divided into five groups： sham-operation group, HLP group, Vit C group, Vit E group and combination group. Rats were killed at 6 h and24 h after induction of the model and drew blood from heart. The value of amylase（AMS）, triglyceride（TG）, lipase（LPS）,superoxide dismutase（SOD）, tumor necrosis factor（TNF-α）, interleukin-6（IL-6） in serum were detected. Under the light microscopy, the histopathologic damage degree of pancreas was observed. Results Compared with control group, the level of TG in the other five groups were significantly increased（t =-3.36,-6.17,-3.38,-0.16,-2.57,-3.18,-4.70,-3.22,-4.01,-3.00,P〈0.05）. At 6 h and 24 h after induction of the model, the TG level of Vit C group, Vit E group and combination group were similar to that in HLP group（t =0.66, 0.32,0.53, 0.20, 0.05, 0.14, P〈0.05）. Compared with HLP group, the level of AMY, LPS, TNF-α,IL-6 in the Vit C group, Vit E group and combination group at 6 h and 24 h after induction of the model were decreased significantly（t=2.40,2.46, 3.13, 4.61, 3.60, 5.59, 1.01, 2.10, 4.95, 2.18, 3.40, 5.92, 11.27, 11.12, 22.82, 10.29, 10.16, 19.32, 3.13,2.55, 5.35, 2.34, 1.73, 5.27, P〈0.05） as well as compared combination group with Vit C group and Vit E group（t=-2.78,-2.37,-3.06,-5.74,-4.27,-3.23,-4.00,-2.25,-11.61,-9.02,-10.50,-9.46,-2.49,-2.95,-2.54,-3.56,P〈0.05）. Compared with HLP group, the level of SOD in the Vit C group, Vit E group and combination group at 6 h and 24 h after induction of the model were significantly higher（t=5.22, 4.96, 8.15, 4.45, 5.59, 9.53,P〈0.05） as well as compared combination group with Vit C group and Vit E group（t=4.09, 3.14, 4.29, 2.79,P〈0.05）.Compared with sham-operation group, the histopathologic scores of pancreas of the HLP group, Vit C group, Vit E group and combination group were obviously higher（t=-19.00,-15.00,-9.03,-11.00,-16.87,-18.00,-17.00,-11.00,P〈0.05） as well as compared HLP group with Vit C group, Vit E group and combination group（t=2.98, 2.16, 5.96, 2.52, 3.16, 5.69,P〈0.05）.The histopathologic scores of pancreas of combination group were significantly lower than that of Vit C group and Vit E group（t=-2.98,-2.16,-3.72,-2.98,P〈0.05）. Conclusion Vit C and Vit E has antioxygenation to HLP, the antioxygenation will more obvious when combined Vit C with Vit E.