CAJ | 학술논문

目的：探讨经皮置管引流(PCD)对重症急性胰腺炎(SAP)大鼠胰腺氧化应激损伤的影响。方法30只 Wistar 大鼠随机分为假手术组(SHAM 组,仅行开腹手术)、SAP 组(逆行胰胆管注射牛磺胆酸钠诱导 SAP 大鼠模型)和 PCD 组(在 SAP 组基础上行 PCD 治疗),每组10只；分别于术后12 h 取血清及腹水测定 TNF-α、淀粉酶、蛋白酶、丙二醛(MDA)水平,留取胰腺组织制作石蜡切片行光镜下病理检查,同时检测胰腺组织中超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、MDA 的含量,Western Blot 检测聚腺苷二磷酸核糖聚合酶[(ADP-ribose) polymerase, PARP]在胰腺组织的表达。结果病理评分及切片提示 SAP 组空泡形成、感染、水肿、坏死、出血损伤程度较 PCD 组更为严重(P <0.05)；SAP 组、PCD 组血清中 TNF-α含量、淀粉酶活性、胰腺组织中 MPO、MDA 的含量、PARP 表达较SHAM 组均明显升高,PCD 组均低于 SAP 组(P <0.05)；PCD 组腹水中 TNF-α、MDA 含量及蛋白酶活性较 SAP 组明显降低(P <0.05)；SAP 组、PCD 组胰腺组织中 SOD 均低于 SHAM 组,PCD 组均高于 SAP 组(P <0.05)。结论 PCD 可通过引流出富含炎症细胞因子及胰酶等有害物质的腹水后减轻 SAP 大鼠胰腺氧化应激损伤而缓解机体病情。
목적：탐토경피치관인류(PCD)대중증급성이선염(SAP)대서이선양화응격손상적영향。방법30지 Wistar 대서수궤분위가수술조(SHAM 조,부행개복수술)、SAP 조(역행이담관주사우광담산납유도 SAP 대서모형)화 PCD 조(재 SAP 조기출상행 PCD 치료),매조10지；분별우술후12 h 취혈청급복수측정 TNF-α、정분매、단백매、병이철(MDA)수평,류취이선조직제작석사절편행광경하병리검사,동시검측이선조직중초양화물기화매(SOD)、수과양화물매(MPO)、MDA 적함량,Western Blot 검측취선감이린산핵당취합매[(ADP-ribose) polymerase, PARP]재이선조직적표체。결과병리평분급절편제시 SAP 조공포형성、감염、수종、배사、출혈손상정도교 PCD 조경위엄중(P <0.05)；SAP 조、PCD 조혈청중 TNF-α함량、정분매활성、이선조직중 MPO、MDA 적함량、PARP 표체교SHAM 조균명현승고,PCD 조균저우 SAP 조(P <0.05)；PCD 조복수중 TNF-α、MDA 함량급단백매활성교 SAP 조명현강저(P <0.05)；SAP 조、PCD 조이선조직중 SOD 균저우 SHAM 조,PCD 조균고우 SAP 조(P <0.05)。결론 PCD 가통과인류출부함염증세포인자급이매등유해물질적복수후감경 SAP 대서이선양화응격손상이완해궤체병정。
Objective To explore the influence of percutaneous catheter drainage (PCD) on the oxidative stress damage in rats with severe acute panreatitis (SAP). Methods Thirty Wistar rats were randomly divided into sham oper-ation group (n = 10) undergoing laparotomy, SAP group (n = 10) in which the SAP rat models were established by injec-ting Sodium Taurocholate regressed pancreas and bile ducts and PCD group (n = 10), which was added with PCD therapy based on the SAP treatment. Rats were killed 12 hours after the operation, and the levels of TNF-α, amylase, trypase and malondialdehyde (MDA) in serum and ascites were detected; paraffin sections of pancreatic tissues underwent patho-logical examination under light microscope, and contents of superoxide dismutase (SOD), myeloperoxidase (MPO) and MDA in pancreatic tissues were detected at the same time; the expression of (ADP-ribose)polymerase (PARP) in the pancreatic tissues was detected by Western Blot. Results Histopathological results and sections showed that the degrees of vacuolization, infection, oedema, necrosis and bleeding injury in SAP group were severe, compared with those in PCD group (P < 0. 05); the levels of TNF-α content and amylase activity in serum, contents of MPO and MDA in pancreatic tissues and PARP expression in SAP and PCD groups were significantly higher than those in sham operation group, and the values in PCD group were also significantly lower than those in SAP group (P < 0. 05); contents of TNF-α and MDA in ascites and trypase activity in PCD group were significantly decreased, compared with those in SAP group (P < 0. 05);the SOD contents in SAP and PCD groups were significantly lower than that in sham operation group, and the content in PCD group was higher than that in SAP group (P < 0. 05). Conclusion PCD can alleviate SAP-induced pancreatic oxi-dative stress damage by drainning harmful ascites, which contains inflammatory cytokine and trypsin.