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目的探讨早期腹腔穿刺引流(abdominal paracentesis drainage,APD)对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠肠道细菌移位的影响。方法将质粒标记有绿色荧光蛋白的大肠杆菌(E.coli marked with green fluorescent protein,GFP-E.coli)灌饲给SD大鼠,使其成功定植于大鼠肠道。将定植了GFP-E.coli的大鼠分为假手术组(Sham组)、SAP组和APD组,每组12只。逆行胰胆管注射5%牛磺胆酸钠制作大鼠SAP模型。SAP造模后于右下腹留置腹腔引流管,为APD治疗组。造模后24 h无菌条件下取材并处死。对比各组大鼠胰腺组织病理学评分,血液、肠系膜淋巴结(mesenteric lymph nodes,MLN)、胰腺组织细菌移位情况,以及血清炎性因子CRP、TNF-α及IL-1β水平。结果与假手术组比较,SAP组及APD组胰腺组织病理学评分,血液、MLN及胰腺组织细菌移位程度,血清内毒素水平,以及血清炎性因子CRP、TNF-α及IL-1β水平均显著升高(P<0.05);与SAP组比较,APD组上述各项指标均显著降低(P<0.05)。结论早期APD能减少SAP大鼠肠道细菌移位及全身炎症水平,并可能因此改善SAP。
Objective To investigate the effects of early abdominal paracentesis drainage (APD) on intestinal bacterial translocation in rats with severe acute pancreatitis (SAP). Methods E. coli cells were transfected with green fluorescent protein (GFP-E.coli) plasmid, and were then successfully inoculated into the intestine of rats. The rats colonized with GFP-E.coli were divided into sham-operation group (Sham group), SAP group and APD group, 12 rats in each group. The rat model of SAP was established by injecting 5% sodium taurocholate into the pancreaticobiliary duct. After modeling SAP in the right lower abdomen abdominal drainage tube for the APD treatment group. 24 h after modeling under sterile conditions and sacrificed. Pathological scores of pancreas, blood, mesenteric lymph nodes (MLN), pancreas bacterial translocation, and serum inflammatory cytokines CRP, TNF-α and IL-1β were compared between the two groups. Results Compared with the sham operation group, the pathological score of pancreatic tissue in SAP group and APD group, the level of bacterial translocation in blood, MLN and pancreas, the level of serum endotoxin and the levels of serum inflammatory cytokines CRP, TNF-α and IL-1β (P <0.05). Compared with SAP group, the above indexes in APD group were significantly decreased (P <0.05). Conclusion Early APD can reduce intestinal bacterial translocation and systemic inflammation in SAP rats and may therefore improve SAP.