肠淋巴途径在重症急性胰腺炎大鼠肾损伤中的作用

Effects of mesenteric lymphatic pathway in acute pancreatitis induced kidney injury in rats

目的观察肠淋巴管结扎对重症急性胰腺炎(SAP)大鼠肾脏功能的影响,探讨肠淋巴途径在重症急性胰腺炎大鼠肾损伤中的作用。方法雄性SD大鼠,随机分为:假手术组(A组)、SAP模型组(B组)和SAP+肠系膜淋巴管结扎组(C组)。各组分别于造模后6、12和24 h处死大鼠取肾脏组织,部分制备组织匀浆,部分用于病理组织学检查。HE染色观察肾组织病理学改变,血生化检测血清尿素氮和肌酐水平,ELISA法测定肾脏组织匀浆中肿瘤坏死因子-α(TNF-α)和白细胞介素-1(IL-1)水平;髓过氧化物酶法检测肾脏组织匀浆髓过氧化酶(MPO)活性。结果 B组大鼠各指标均较A组明显升高;与B组相比较,C组血清肌酐(SCr)和尿素氮(BUN)水平在12 h和24 h后明显降低(P<0.05),肾脏病理学损伤明显改善,肾脏组织匀浆中TNF-α、IL-1水平和MPO活性在3个时间点均明显降低(P<0.05)。结论肠淋巴途径在SAP大鼠肾损伤的发生发展中扮演重要作用,结扎肠淋巴管可减轻SAP大鼠炎性因子移位所致的肾损伤。

Objective To investigate the effect of mesenteric lymphatic ligation in acute pancreatitis induced kidney injury. Methods Male SD rats were randomly divided into three groups,the acute pancreatitis group（ A）,the acute pancreatitis and ligation group（ B）,and the sham operated group（ C）. Rats were killed 6 h,12 h,24 h after model establishment and kidney and intestine tissue was collected,part of it as homogenates,the rest of it for histological observation. HE staining was used to detect pathological changes in kidney tissue. The levels of blood urea nitrogen（ BUN）,serum creatinine（ Scr） were measured by automatic biochemical analyzer. Enzyme- linked immunosorbent assay（ ELLSA）was used to measure the levels of tumor necrosis factor- a（ TNF- α）,interleukin- 1（ IL- 1） in kidney and intestine tissue homogenates. Enzyme myeloperoxidase assay was used to detect the level of myeloperoxidase（ MPO）. Results All levels of biomarkers in Group B were elevated compared with Group A（ P〈0. 05）. Levels of Scr and BUN at 12 h and 24 h in Group C was significantly reduced compared with Group B. Pathological damage was milder in Group C than in Group B.TNF- α,IL- 1 levels and MPO activity were significantly lower at all time points in Group C than in Group B（ P〈0. 05）. Conclusion The mesenteric lymphatic pathway is of important effect in acute pancreatitis induced kidney injury.Mesenteric lymphatic ligation might alleviate kidney injury caused by inflammatory cytokine translocation in acute pancreatitis.