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目的 探讨重症急性胰腺炎(SAP)大鼠模型肿瘤坏死因子(TNF) α与血清钙水平的关系。方法 胰管内逆行注射5 %牛磺胆酸钠的方法建立SAP大鼠模型。将SD大鼠分为假手术组2 1只,SAP组2 1只,治疗组2 1只。治疗组为模型制作前15min自阴茎背静脉注入抗肿瘤坏死因子α单克隆抗体(TNF αMcAb ,5mg/kg体重) ,观察血中TNF α与血钙的水平。酶联免疫吸附法(ELISA)测定细胞因子水平。结果 重症急性胰腺炎TNF α水平与血钙之间呈显著负相关(r =-0 .69,P <0 .0 1) ,在发病初期两者关系更紧密(6h组:r =-0 .73 ,P <0 .0 1)。TNF αMcAb能改善胰腺病理变化、降低淀粉酶、降低血清TNF α、升高血钙,6hSAP组血清钙(1.99±0 .0 3 )mmol/L ,TNF αMcAb治疗组血清钙(2 .0 6±0 .0 6)mmol/L ,P <0 .0 5 ;12hSAP组血清钙(1.88±0 .0 5 )mmol/L ,TNF αMcAb治疗组血清钙(1.94±0 .0 5 )mmol/L(P <0 .0 5 )。结论 TNF α可能在SAP并发低钙血症的机制中发挥作用,尤其在疾病发生的早期
Objective To investigate the relationship between serum tumor necrosis factor (TNF) α and serum calcium in severe acute pancreatitis (SAP) rats. Methods The rat model of SAP was established retrograde injection of 5% sodium taurocholate into the pancreatic duct. SD rats were divided into sham operation group 21, SAP group 21, treatment group 21 only. In the treatment group, the anti-tumor necrosis factor α monoclonal antibody (TNF αMcAb, 5 mg / kg body weight) was injected into the dorsal penile vein 15 min before the model was made. The levels of TNF α and serum calcium were observed. Cytokine levels were measured by enzyme-linked immunosorbent assay (ELISA). Results There was a significant negative correlation between TNFα and serum calcium in patients with severe acute pancreatitis (r = -0.69, P <0.01). 73, P <0. 01). TNFαMcAb can improve pancreatic pathological changes, reduce amylase, lower serum TNFα, increase serum calcium, 6hSAP serum calcium (1.99 ± 0.30mmol / L, TNFαMcAb treatment serum calcium (2.60 ± (1.88 ± 0.55) mmol / L for 12hSAP group and 1.94 ± 0.05mmol / L for serum TNF-αMcAb group (P> 0.05) P <0. 05). Conclusion TNF α may play a role in the mechanism of SAP complicated with hypocalcemia, especially in the early stage of disease