目的 探讨肠道缺血再灌注(IIR)在出血坏死性胰腺炎(HNP)早期炎性反应中的作用.方法 根据随机数字表法将80只大鼠分为4组,每组20只:假手术组(SO组),急性水肿型胰腺炎组(AEP组),急性水肿型胰腺炎合并肠道缺血再灌注组(AEP+ IIR组)和出血坏死性胰腺炎组(HNP组).于建立模型后0、1、2、3、6h分别检测小肠系膜微循环红细胞流速(EV)、功能毛细血管密度(FCD)及白细胞黏附数(LA),并测定血清TNF-α及IL-6水平.多组比较采用方差分析,两两比较采用t检验.结果 AEP组EV在1h明显下降,在3h升高,但仍显著低于SO组(t=9.60,P＜0.05);而AEP+ IIR组及HNP组EV则持续下降,直至6h升高,但仍显著低于AEP组(t=6.03,6.12,P＜0.05).AEP组FCD在3h时显著低于SO组(t=8.20,P＜0.05);而AEP+ IIR组及HNP组FCD在3h后显著低于AEP组(t=35.60,23.80,P＜0.05).AEP组LA在1h较SD组明显升高(t=75.00,P＜0.05),在3h达到峰值;而AEP+ IIR组及HNP组LA在1、2、3、6h均显著高于AEP组(t=23.00,29.50,53.00,38.70,23.10,48.20,39.20,47.50,P＜0.05).与SO组比较,AEP组TNF-α在1h显著升高(t=77.00,P＜0.05),3h后逐渐下降,而AEP+ IIR组及HNP组TNF-α在2h后显著高于AEP组(t=23.50,18.10,P＜0.05).AEP组IL-6水平在1、2、3、6h持续高于SO组(t=93.50,146.00,243.60,209.20,P＜0.05),而AEP+ IIR组及HNP组IL-6在1h与AEP组比较,差异无统计学意义(t =2.30,2.03,P＞0.05),但在2h后显著高于AEP组(t=35.63,29.80,P＜0.05).结论 IIR可进一步加重AEP早期炎性反应,提示IIR是HNP早期发生、发展的重要促进因素.
目的 探討腸道缺血再灌註(IIR)在齣血壞死性胰腺炎(HNP)早期炎性反應中的作用.方法 根據隨機數字錶法將80隻大鼠分為4組,每組20隻:假手術組(SO組),急性水腫型胰腺炎組(AEP組),急性水腫型胰腺炎閤併腸道缺血再灌註組(AEP+ IIR組)和齣血壞死性胰腺炎組(HNP組).于建立模型後0、1、2、3、6h分彆檢測小腸繫膜微循環紅細胞流速(EV)、功能毛細血管密度(FCD)及白細胞黏附數(LA),併測定血清TNF-α及IL-6水平.多組比較採用方差分析,兩兩比較採用t檢驗.結果 AEP組EV在1h明顯下降,在3h升高,但仍顯著低于SO組(t=9.60,P＜0.05);而AEP+ IIR組及HNP組EV則持續下降,直至6h升高,但仍顯著低于AEP組(t=6.03,6.12,P＜0.05).AEP組FCD在3h時顯著低于SO組(t=8.20,P＜0.05);而AEP+ IIR組及HNP組FCD在3h後顯著低于AEP組(t=35.60,23.80,P＜0.05).AEP組LA在1h較SD組明顯升高(t=75.00,P＜0.05),在3h達到峰值;而AEP+ IIR組及HNP組LA在1、2、3、6h均顯著高于AEP組(t=23.00,29.50,53.00,38.70,23.10,48.20,39.20,47.50,P＜0.05).與SO組比較,AEP組TNF-α在1h顯著升高(t=77.00,P＜0.05),3h後逐漸下降,而AEP+ IIR組及HNP組TNF-α在2h後顯著高于AEP組(t=23.50,18.10,P＜0.05).AEP組IL-6水平在1、2、3、6h持續高于SO組(t=93.50,146.00,243.60,209.20,P＜0.05),而AEP+ IIR組及HNP組IL-6在1h與AEP組比較,差異無統計學意義(t =2.30,2.03,P＞0.05),但在2h後顯著高于AEP組(t=35.63,29.80,P＜0.05).結論 IIR可進一步加重AEP早期炎性反應,提示IIR是HNP早期髮生、髮展的重要促進因素.
목적 탐토장도결혈재관주(IIR)재출혈배사성이선염(HNP)조기염성반응중적작용.방법 근거수궤수자표법장80지대서분위4조,매조20지:가수술조(SO조),급성수종형이선염조(AEP조),급성수종형이선염합병장도결혈재관주조(AEP+ IIR조)화출혈배사성이선염조(HNP조).우건립모형후0、1、2、3、6h분별검측소장계막미순배홍세포류속(EV)、공능모세혈관밀도(FCD)급백세포점부수(LA),병측정혈청TNF-α급IL-6수평.다조비교채용방차분석,량량비교채용t검험.결과 AEP조EV재1h명현하강,재3h승고,단잉현저저우SO조(t=9.60,P＜0.05);이AEP+ IIR조급HNP조EV칙지속하강,직지6h승고,단잉현저저우AEP조(t=6.03,6.12,P＜0.05).AEP조FCD재3h시현저저우SO조(t=8.20,P＜0.05);이AEP+ IIR조급HNP조FCD재3h후현저저우AEP조(t=35.60,23.80,P＜0.05).AEP조LA재1h교SD조명현승고(t=75.00,P＜0.05),재3h체도봉치;이AEP+ IIR조급HNP조LA재1、2、3、6h균현저고우AEP조(t=23.00,29.50,53.00,38.70,23.10,48.20,39.20,47.50,P＜0.05).여SO조비교,AEP조TNF-α재1h현저승고(t=77.00,P＜0.05),3h후축점하강,이AEP+ IIR조급HNP조TNF-α재2h후현저고우AEP조(t=23.50,18.10,P＜0.05).AEP조IL-6수평재1、2、3、6h지속고우SO조(t=93.50,146.00,243.60,209.20,P＜0.05),이AEP+ IIR조급HNP조IL-6재1h여AEP조비교,차이무통계학의의(t =2.30,2.03,P＞0.05),단재2h후현저고우AEP조(t=35.63,29.80,P＜0.05).결론 IIR가진일보가중AEP조기염성반응,제시IIR시HNP조기발생、발전적중요촉진인소.
Objective To investigate the effects of intestinal ischemia reperfusion (IIR) on the progression of inflammatory reaction in hemorrhagic necrosis pancreatitis (HNP).Methods Eighty rats were randomly divided into sham operation (SO) group,acute edematous pancreatitis (AEP) group,AEP + IIR group and HNP group according to the random number table.Erythrocyte velocity (EV),functional capillary density (FCD) and leukocyte adherence (LA) were observed at 0,1,2,3 and 6 hours after the models were completed.The serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected.All data were analyzed by using the analysis of variance or the t test.Results The level of EV in the AEP group significantly decreased at 1 hour,and got increased at 3 hours,while the level of EV in the AEP group was still significantly lower than that in the SO group ( t =9.60,P ＜ 0.05 ).The levels of EV in the AEP + IIR group and HNP group constantly decreased,and increased at 6 hours,but were continually lower than that in the AEP group ( t =6.03,6.12,P ＜0.05 ).The level of FCD in the AEP group was significantly lower than that in the SO group at 3 hours ( t =8.20,P＜0.05).The levels of FCD in the AEP + IIR group and HNP group were significantly lower than that in the AEP group at 3 hours (t =35.60,23.80,P ＜ 0.05 ).Compared with AEP group,the level of LA in the AEP group was significantly increased at 1 hour ( t =75.00,P ＜ 0.05 ) and reached peak at 3 hours.The levels of LA in the AEP + IIR group and HNP group were significantly higher than that in the AEP group at 1,2,3,6 hours (t =23.00,29.50,53.00,38.70,23.10,48.20,39.20,47.50,P＜0.05).Compared with SO group,the level of TNF-α in the AEP group significantly increased since l hour (t =77.00,P ＜ 0.05),and began to decrease at 3 hours; the levels of TNF-α in the AEP +IIR group and HNP group at 2 hours were significantly higher than that in the AEP group (t =23.50,18.10,P＜0.05).The levels of IL-6 in the AEP group at 1,2,3,6 hours were significantly higher than those in the SO group ( t =93.50,146.00,243.60,209.20,P ＜ 0.05 ).The levels of IL-6 in the AEP + IIR group and HNP group at 1 hour were not significantly different from that in the AEP group ( t =2.30,2.03,P ＞ 0.05),while the levels of IL-6 in the AEP + IIR group and HNP group at 2 hours were significantly higher than that in the AEP group (t =35.63,29.80,P ＜ 0.05 ).Conclusion IIR may enhance the inflammatory reaction of AEP and IIR might be one of the factors to exaggerate the inflammatory reaction of HNP.
