早期腹腔置管引流与重症急性胰腺炎肠黏膜HMGB1表达实验研究.docVIP

早期腹腔置管引流与重症急性胰腺炎肠黏膜HMGB1表达实验研究 　　[摘要] 目的 探讨早期腹腔置管引流对重症急性胰腺炎肠黏膜HMGB1表达的影响及意义。 方法 将SD大鼠（n=60）随机分为A组（SAP模型组，n=20）、B组（腹腔置管治疗组，n=20）和SO组（对照组，n=20）。A、B组大鼠均泵入5%牛磺胆酸钠建立SAP模型，B组大鼠在建立SAP模型的同时予以留置腹腔引流管一根，SO组大鼠开腹仅翻动十二指肠。三组大鼠均在建模后24 h开腹，观察大鼠腹腔内改变，检测AMY、DAO浓度，检测小肠黏膜HMGB1的表达水平，观察小肠和胰腺的病理改变。 结果 A、B组大鼠血AMY、DAO浓度、小肠黏膜HMGB1的表达水平、小肠和胰腺病理学改变均显著优于SO组（P0.05），但与A组比较，B组上述指标均显著降低（P0.05）。 结论 大鼠SAP肠黏膜的损伤可能与肠黏膜HMGB1的表达增加有关。早期腹腔置管引流能减轻大鼠SAP肠黏膜的损伤。 　　[关键词] 早期腹腔置管引流；重症急性胰腺炎；高迁移率族蛋白1；肠黏膜损伤 　　[中图分类号] R657.51 [文献标识码] A [文章编号] 1673-9701（2016）21-0025-03 　　[Abstract] Objective To study the influences and significance of HMGB1 expression intestinal mucosal damage by severe acute pancreatitis（SAP） with early peritoneal catheter drainage. Methods 60 SD rats were randomly divided into three group： the group A（n=20）； the group B（n=20）； group SO（n=20）. The rats of group A， B were all injected with 5% sodium taurocholate to establish the SAP model， but the rats in group B was to be indwelling peritoneal drainage tube while SAP model， and the pancreas of the rats were turned up only in group SO. The three groups rats were opened abdominal again after 24 h to detect the concentration of AMY， DAO of the serum and the expression of HMGB1 in the intestinal， and pathological changes in the intestinal mucosal and pancreas. Results The concentrations of AMY， DAO in the serum of the blood and the expression of HMGB1 in the intestinal mucosal and pathological changes in the intestinal mucosal and pancreas were significantly better in the group A， B than group SO， but compared with group A， group B was significantly decreased（P0.05）. Conclusion The damage of intestinal mucosal in SAP may be related with the high expression of HMGB1 in the intestinal mucosal， the early peritoneal catheter drainage can reduce the intestinal mucosa damage in the SAP rats. 　　[Key words] Early peritoneal catheter drainage； Severe acute pancreatitis； HMGB1； Intestinal mucosal damage 　　重症急性胰腺炎（severe acute pancreatitis，SAP）是一种病情严重、治疗困难、发