TNF-α对重症急性胰腺炎大鼠脏器功能影响.doc

TNF-α对重症急性胰腺炎大鼠脏器功能影响 　【摘要】 目的 通过动物实验探讨肿瘤坏死因子-α（TNF-α）对重症急性胰腺炎大鼠脏器功能的影响。方法 40只SD雄性大鼠分两组，每组20只。普通SAP组以5%牛磺胆酸钠建立重症急性胰腺炎（SAP）；TNF-α加重组，在普通SAP组基础上增加TNF-α腹腔注射。制模10 h后各处死10只，检测其血液生化和细胞因子浓度，观察组织脏器的病理变化。结果 TNF-α加重组大鼠血清的丙氨酸氨基转移酶、肌酐和TNF-α与普通SAP组相比有明显升高。同时，该组大鼠的肝脏、肺脏和肾脏病理评分显著大于普通SAP组。结论 TNF-α可能在胰腺炎重症化及MODS发生发展过程中起重要作用。 【关键词】 重症急性胰腺炎 肿瘤坏死因子-α Affection of TNF-α on organ function of severe acute pancreatitis in the rats ［Abstract］ Objective To investigate the affection of TNF-α on organ function of severe acute pancreatitis by establishing animal models of the disease.Methods Forty SD rats were divided into 2 groups with 20 rats each group.The rats in group A were given retrograde injection of 5% sodium taurocholate into the pancreatic duct as severe acute pancreatitis （SAP） model.Intraperitoneal injection of TNF-α was given to the animals in group B besides the pancreatic duct injection of 5% sodium taurocholate.The changes in organ functions were observed by biochemistry and pathological examination was made 10 hours later after modeling.Results The increase in GPT and creatinine in blood was found in the rats in Group B when compared with the rats in Group A.The severe pathological lesion was present as pathology score of liver，lung and kidney in rats of Group B when compared with those in rats of Group A.Conclusion TNF-α play an important role in the organ dysfunction in severe acute pancreatitis. ［Key words］ severe acute pancreatitis;TNF-α 重症急性胰腺炎（SAP）是外科急腹症中最为严重的疾病之一，其中伴有脏器功能障碍的SAP更是死亡率极高。研究表明［1］，SAP发病早期胰腺腺泡细胞可以产生、释放肿瘤坏死因子-α（TNF-α），同时局部组织中被激活的单核巨噬细胞也可产生大量TNF-α。SAP于发病1 h后即可在胰腺及血浆中测得TNF-α，并在6 h内急剧上升［2］。笔者以SAP大鼠模型为基础，通过腹腔注射TNF-α来模拟早期即有大量促炎因子生成的SAP，观察其对重症急性胰腺炎大鼠脏器功能的影响。 1 材料与方法 1.1 材料 雄性SD大鼠40只，体重300～400 g，购自中科院上海分院实验动物部。牛磺胆酸钠（纯度99%），购自Sigma公司，用生理盐水配制成5％牛磺胆酸钠溶液。TNF-α购自Ramp;D System公司。丙氨酸氨基转移酶及肌酐测定试剂盒购自上海生物制品研究所。α-淀粉酶试剂盒购自上海科华-东菱诊断用品公司。大鼠TNF-α kit购自Biosource公司。主要仪器包括低温高速离心机（Beckman公司）、uQuant酶标仪（BIO-TEK公司）、DU640分光光度计（Beckman公司）、CHK2-F-GS光学显微镜（Olympus公司）、BX50病理摄片仪（Olympus公