重症急性胰腺炎肺损伤与肺微循环及炎症介质变化的相关性研究

Relationship between lung injury and lung miocrocirculation,inflammatory mediators in rats with severe acute pancreatitis

目的 探讨重症急性胰腺炎 (SAP)时肺损伤与肺微循环、血清白介素 - 1β(IL - 1β)及磷脂酶A2 (PLA2 )变化的关系。方法 SD大鼠 6 4只 ,随机分成对照组与SAP组。 5 %牛磺胆酸钠胰腺被膜下均匀注射制成SAP模型。采用放射性生物微球技术在制模后 2h及 12h分别测定肺血流量 ,同时观察血清IL - 1β水平与PLA2 活性及肺组织学改变。结果 SAP组制模后 2h、12h肺血流量〔(2 75± 0 4 4 )、(2 4 3± 0 4 2 )mL·min-1·g-1〕均较对照组〔(3 5 5± 0 5 1)、(3 5 1± 0 37)mL·min-1·g-1〕明显降低 (P =0 0 0 4、0 0 0 0 ) ;血清IL - 1β〔(0 78± 0 13)、(0 83± 0 2 0 ) μg/L〕、PLA2 〔(94 2 9± 9 96 )、(10 3 71± 14 4 0 )U/L〕均较对照组〔(0 32± 0 0 6 )、(0 33± 0 0 7) μg/L ,(6 5 2 7± 10 5 2 )、6 6 6 3± 9 81)U/L〕明显增高 (P均 =0 0 0 0 ) ;肺组织学损伤在 2h、12h均较对照组明显加重 (P =0 0 0 4、0 0 0 1)。SAP后 2h、12h肺损伤与肺血流量、血清IL - 1β及PLA2 均密切相关 (P =0 0 4 4～ 0 0 0 1)。结论 SAP大鼠肺微循环障碍和IL - 1β、PLA2 的过度激活是造成SAP肺损伤的重要原因。

Objective To study the relationship between lung injury and lung miocrocirculation,serum interleukin-1β(IL-1β)and phospolipase A 2(PLA 2)in rats with severe acute pancreatitis(SAP).Methods A total of 64 rats were randomized into control group and SAP group.The model of SAP was established by injection of 5% sodium taurocholate into pancreatic capsule.Redioactive biomicrosphere technique was used to measure the blood flow of lung at 2 h and 12 h after SAP.Meanwhile,blood samples and lung tissues were collected to observe the changes of IL-1β,PLA 2 and lung histology.Results The pulmonary blood flow in SAP group 〔(2 75±0 44),(2 43±0 42)mL·min -1 ·g -1 〕was significantly lower than control group 〔(3 55±0 51),(3 51±0 37)mL·min -1 ·g -1 〕(P=0 004,0 000 respectively),the IL-1β 〔(0 78±0 13),(0 83±0 20)μg/L〕,PLA 2〔(94 29±9.96),(103 71±14 40)U/L〕(all P=0.000)at 2 h and 12 h after SAP Comparing with control group, the pulmonary pathological changes and infiltrating degrees of neutrophils were aggravated significantly( P =0.004～0.000)at 2 h and 12 h in SAP group.The lung injury was closely correlated with pulmonary blood flow, IL-1β levels and PLA 2 activity in serum(P=0.044～0.001) Conclusion The pulmonary microcirculation disorder and increasement of IL-1β and PLA 2 in serum may play an important role in lung injury of SAP.