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参附注射液减轻重症急性胰腺炎大鼠肠屏障功能障碍及二次打击损伤
邹忠东,张再重,唐力军,涂小煌,王烈,王瑜*
0
(南京军区福州总医院普通外科研究所,福州 350025)
摘要:
目的:探讨参附注射液(Shenfu injection,SFI)对重症急性胰腺炎(SAP)大鼠肠屏障功能障碍与二次打击的防护作用。方法:雄性Wistar大鼠54只,随机分为3组:SAP组(SAP,n=24),采用逆行十二指肠胰胆管注射5%牛黄胆酸钠溶液制备SAP大鼠模型;SAP+SFI组(n=24),建模前2 h先给予SFI 10 ml/kg 体质量腹腔注射;假手术组(SO,n=6)。建模成功后3、6、12、24 h,分别取血液和小肠、胰腺、肺脏、肝脏标本。光镜下观察小肠组织病理改变,检测各时段血浆TNF-α、IL-6和二胺氧化酶(diamine oxidase,DAO)活性,以及相应时段胰腺、肺脏、肝脏中髓过氧化物酶(MPO)含量。结果:SAP组各时间点血液TNF-α、IL-6、DAO均较SO组显著升高(P<0.01),6~24 h胰腺、肺脏、肝脏MPO较SO组显著升高(P<0.01);SAP+SFI组各时间点血液DAO、TNF-α和IL-6水平显著低于SAP组(P<0.05或P<0.01),6~24 h胰腺、肺脏、肝脏MPO显著低于SAP组(P<0.05或P<0.01);SAP+SFI组建模后24 h小肠病理组织改变较SAP组明显减轻。结论:SFI可防护SAP大鼠肠屏障功能障碍,并可减轻胰腺、肺脏、肝脏遭受二次打击的严重程度,其作用机制可能与减少中性粒细胞聚集、抑制促炎细胞因子TNF-α、IL-6相关。
关键词:  参附注射液  重症急性胰腺炎  肠屏障功能障碍  二次打击  细胞因子
DOI:10.3724/SP.J.1008.2009.0913
投稿时间:2008-11-20修订日期:2009-07-10
基金项目:福建省自然科学基金(2006J0372).
Protective effect of Shenfu injection against intestinal barrier dysfunction and second hit in rats with severe acute pancreatitis
ZOU Zhong-dong,ZHANG Zai-zhong,TANG Li-jun,TU Xiao-huang,WANG Lie,WANG Yu*
(Research Institute of General Surgery,Fuzhou General Hospital,PLA Nanjing Military Area Command,Fuzhou 350025,China)
Abstract:
Objective:To evaluate the protective effect of Shenfu injection (SFI) against intestinal barrier dysfunction and second hit in rats with severe acute pancreatitis (SAP).Methods:Fifty-four male Wistar rats were randomly divided into sham operation group (n=6),SAP group (n=24),and SAP+SFI group (10 ml/kg body wt,n=24).Sham operation group underwent laparotomy only.SAP model was established by retrograde injection of 5% sodium taurocholate into the bili-pancreatic duct of Wistar rats.SAP+SFI group was given SFI (10 ml/kg) intaperitoneally 2 h before SAP establishment.Rats were sacrificed at 3,6,12 and 24 hours after operation.The samples of pancreas,lung and liver were collected for measuring the levels of myeloperoxidase (MPO) at 3,6,12,and 24 h after injection of sodium taurocholate.The pathological changes of the terminal ilea were observed under light microscopy,and the blood levels of diamine oxidase (DAO),tumor necrosis factor alpha (TNF-α) and interleukin-6(IL-6) were also measured at different time points.Results:The blood levels of TNF-α,IL-6 and DAO in SAP group were significantly higher than those in the sham operation group at all time points (P<0.01).The levels of intrapulmonary,intrapancreatic and intrahepatic MPO in SAP group were significantly than those in the sham operation group at 6,12,and 24 hours (P<0.01).The contents of DAO,TNF-α and IL-6 were significantly decreased in SAP+SFI group compared with in SAP group at all time points(P<0.05 or P<0.01).The contents of intrapulmonary,intrapancreatic and intrahepatic MPO were significantly decreased in SAP+SFI group compared with SAP group at 6,12, and 24 h after operation(P<0.05 or P<0.01).Intestinal pathological damages were obviously milder in SAP+SFI group than that in SAP group at 24 h after operation.Conclusion:SFI can protect the small intestine mucosal barrier and other organs from second hit by reducing the polymorphonuclear leucocyte detaining and inhibiting TNF-α and IL-6.
Key words:  Shenfu injection  severe acute pancreatitis  intestine barrier functional disturbance  second attack  cytokines