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目的观察大黄素对重症急性胰腺炎(SAP)大鼠瘦素水平的影响,探讨其保护SAP胰腺损伤的机制。方法72只Wistar大鼠随机分为3组,每组12只。模型组(SAP)、大黄素组(EM)均以6%牛磺胆酸钠经胰管内逆行注射(1 ml/kg)复制SAP模型,SAP组、EM组分别于造模后30 min腹腔注射生理盐水、大黄素溶液(1 ml/100 g),每天2次,连续3 d。假手术组(SO)于胰胆管内注射生理盐水。测定24 h、48 h时点血清淀粉酶、脂肪酶、TNF-α、IL-10以及瘦素水平。结果24 h时点SAP组血中淀粉酶[(9784.80±2634.89)U/L]显著高于EM组[(7832.67±2641.29)U/L]及SO组[(611.33±209.75)U/L],P<0.01;脂肪酶水平有相似变化趋势。24 h时点SAP组血中TNF-α[(517.76±98.98)pg/ml]显著高于EM组[(259.10±50.08)pg/ml]及SO组[(249.08±83.02)pg/ml],P<0.01。24h时EM组血中IL-10为(677.99±154.07)pg/ml,高于SAP组[(637.73±323.90)pg/ml]。SAP组、EM组的瘦素水平上调,24 h时点EM组[(23.91±4.61) ng/ml]显著高于SAP组[(13.61±8.75)ng/ml](P<0.05)。病理结果显示SAP组胰腺间质水肿、出血,腺泡坏死、炎性细胞浸润严重,EM组病变相对较轻。免疫组化法检测胰腺瘦素表达上调,阳性率增加。结论在重症急性胰腺炎早期,大黄素能够抑制炎性反应,并上调大鼠的瘦素水平,减轻胰腺的病理变化,对胰腺起到保护作用。
Objective To observe the effect of emodin on serum leptin level in severe acute pancreatitis (SAP) rats, and to explore its protective mechanism of SAP pancreatic injury. Methods Seventy-two Wistar rats were randomly divided into 3 groups, 12 in each group. The model group (SAP) and emodin group (EM) all replicated the SAP model with 6% sodium taurocholate injected intraperitoneally (1 ml/kg). SAP group and EM group were intraperitoneally injected 30 min after modeling. Normal saline, emodin solution (1 ml/100 g), 2 times a day for 3 days. The sham operation group (SO) was injected with saline in the pancreatic ducts. Serum amylase, lipase, TNF-α, IL-10 and leptin levels were measured at 24 h and 48 h. Results The amylase level in the SAP group was significantly higher than that in the EM group and the SO group at the time of 24 h (9784.80±2634.89 U/L) [(7832.67±2641.29) U/L] and [(611.33±209.75) U/L]. P<0.01; Lipase levels have similar trends. The serum TNF-α [(517.76±98.98) pg/ml] in SAP group was significantly higher than that in EM group [(259.10±50.08) pg/ml] and SO group [(249.08±83.02) pg/ml] at 24 h. P<0.01. At 24h, IL-10 in EM group was (677.99±154.07) pg/ml, higher than that in SAP group ([637.73±323.90) pg/ml]. The levels of leptin in the SAP and EM groups were up-regulated. The EM group was significantly higher than the SAP group at the 24 h time [(23.91±4.61) ng/ml] [(13.61±8.75) ng/ml] (P<0.05). The pathological results showed that pancreatic interstitial edema, hemorrhage, acinar necrosis, and inflammatory cell infiltration were severe in the SAP group, and the lesions in the EM group were relatively mild. The expression of leptin in the pancreas was up-regulated by immunohistochemistry and the positive rate was increased. Conclusion In the early stage of severe acute pancreatitis, emodin can inhibit the inflammatory response, increase the leptin level in rats, reduce the pathological changes of the pancreas, and protect the pancreas.