摘要
目的探讨TNF-α抑制剂和乌司他定联合应用对重症急性胰腺炎(severe acute pancreatitis,SAP)治疗是否有协同治疗作用。方法采用逆行性胰胆管注射5%牛磺胆酸钠制备SAP模型。80只SD大鼠随机分为假手术组(n=20)、SAP组(n=20)、治疗Ⅰ组(乌司他定治疗组,n=20)、治疗Ⅱ组(TNF-α抑制剂联合乌司他定治疗组,n=20)。各组模型建立后12h处死动物,测血清TNF-α、淀粉酶;应用TUNEL检测细胞凋亡并计算凋亡指数(apoptotic index,AI);免疫组化法检测胰腺组织NF-κB及ET-1阳性细胞表达,对胰腺组织进行病理学检查。结果治疗Ⅰ组、治疗Ⅱ组两组与SAP组相比,除凋亡指数偏高外,其余各项指标均较SAP组低(P<0.05);治疗Ⅱ组的TNF-α、淀粉酶、胰腺组织NF-κB和ET-1表达及病理学评分较治疗Ⅰ组明显偏低(P<0.05),而细胞凋亡指数比治疗Ⅰ组高(P<0.05)。结论联合应用乌司他定和TNF-α抑制剂治疗重症急性胰腺炎能更有效抑制重症急性胰腺炎恶化,控制炎症反应,改善胰腺微循环。
Objective To investigate the influence of inhibitor of tumor necrosis factor-α combined with ulinastatia on the severe acute pancreatitis in rats. Methods The rat＇s models of the SAP was established with 5% sodium taurocholate injected retrogradely into the biliary-pancreatic duct. Eighty SD rats were randomly divided into 4 groups （n=20 in each group）, including sham group, SAP group, treatment group Ⅰ and treatment group Ⅱ. After establishing these models, the rats were killed after 12 h. The contents of serum-amylasem, TNF-α were detected. Apoptotic cells were detected with TUNEL and the apoptotic index was calculated. Nuclear-κB and ET-1 were detected with immunohistochemieal method. The pathological examination of the pancreatic tissue samples was performed. Results The indicators in SAP group were significantly higher than that in the treatment group Ⅰ and treatment group Ⅱ except the apoptotic index （P〈0.05）. The contents of TNF-α, serum amylase, NF-KB, ET-1 and pathological score in the treatment group Ⅱ were lower than that in treatment group Ⅰ （P〈0.05）, but the apoptotie index was higher than that in the treatment group Ⅰ （P〈 0.05）. Conclusion The ulinastatia combined with inhibitor of tumor necrosis factor-or may control the dete- rioration of severe acute pancreatitis and control the inflammatory response and ameliorate the mierocirculation effectively.
出处
《肝胆胰外科杂志》
CAS
2009年第5期356-358,362,共4页
Journal of Hepatopancreatobiliary Surgery
基金
安徽省卫生厅基金资助项目(05A004)
