CAJ | 학술논문

目的：探讨外源性ghrelin在大鼠SAP肾损伤中的作用及机制。方法72只Wistar大鼠随机分为假手术组（SO组，n=24）、重症急性胰腺炎模型组（SAP组，n=24）和ghrelin干预组（G组，n=24）。 SAP组、G组均用3.5%牛磺胆酸钠（1ml/kg）按胰胆管逆行注射法制成重症急性胰腺炎模型，G组在制模前30min和制模后3h腹腔内注射ghrelin（10nmol/kg），SO组、SAP组于相同时间注射等量生理盐水，各实验组大鼠于制模后6h、12h和24h分批取材。光学显微镜下对胰腺和肾脏组织进行病理学评分，全自动生化仪检测血清淀粉酶，酶联免疫吸附法检测血清IL-6、TNF-α、肌酐。结果①SAP组6h、12h、24h血清淀粉酶、肌酐、TNF-α、IL-6，胰腺及肾脏病理评分均较同时间点SO组升高，差异有统计学意义（P<0.05）；②G组6h、12h、24h血清淀粉酶、肌酐、TNF-α、IL-6，胰腺及肾脏病理评分均较同时间点SAP组下降，差异有统计学意义（P<0.05），但均较同时间点SO组升高，差异有统计学意义（P<0.05）。结论外源性ghrelin通过降低TNF-α、IL-6的水平，减轻炎症反应来减轻SAP的严重程度，同时保护肾脏的生理功能。
목적：탐토외원성ghrelin재대서SAP신손상중적작용급궤제。방법72지Wistar대서수궤분위가수술조（SO조，n=24）、중증급성이선염모형조（SAP조，n=24）화ghrelin간예조（G조，n=24）。 SAP조、G조균용3.5%우광담산납（1ml/kg）안이담관역행주사법제성중증급성이선염모형，G조재제모전30min화제모후3h복강내주사ghrelin（10nmol/kg），SO조、SAP조우상동시간주사등량생리염수，각실험조대서우제모후6h、12h화24h분비취재。광학현미경하대이선화신장조직진행병이학평분，전자동생화의검측혈청정분매，매련면역흡부법검측혈청IL-6、TNF-α、기항。결과①SAP조6h、12h、24h혈청정분매、기항、TNF-α、IL-6，이선급신장병리평분균교동시간점SO조승고，차이유통계학의의（P<0.05）；②G조6h、12h、24h혈청정분매、기항、TNF-α、IL-6，이선급신장병리평분균교동시간점SAP조하강，차이유통계학의의（P<0.05），단균교동시간점SO조승고，차이유통계학의의（P<0.05）。결론외원성ghrelin통과강저TNF-α、IL-6적수평，감경염증반응래감경SAP적엄중정도，동시보호신장적생리공능。
Objective To investigate the mechanisms involved in the therapeutic effect of ghrelin administration on the severity of acute kidney injury in severe actue pancreatitis(SAP) of rats. Methods Seventy-two wistar rats were randomly di-vided into shamoperated group (group SO, n=24), severe acute pancreatitis group (group SAP, n=24) and ghrelin intervention group(group G, n=24). SAP was induced in rats of group SAP and group G by 3.5%sodium taurocholate injection through pan-creaticobiliary duct. In group G, the rats were injected ghrelin intraperitoneally by 10nmol/kg(0.5h before and 3h after the oper-ation). In group SAP and SO, the rats were injected the same normal saline intraperitoneally at the same time. The tissue and blood of rats were taken at 6 hours,12h and 24h after operation respectively. The pathologic changes of pancreas and kidney were observed and graded under a optical microscope. The level of serum amylase, creatinine, TNF-α, IL-6 were determined by radio-immunoassay. Results ①In group SAP, the level of serum amylase,creatinine,TNF-α, IL-6,the pathologic scores of the pancreas and kidney were significantly higher than those at the same time in group SO (P<0.05);②In group G, the level of serum amylase,creatinine,TNF-α, IL-6, the pathologic scores of the pancreas and kidney were significantly lower than those at the same time in group SAP(P<0.05), but still significantly higher than those at the same time in group SO(P<0.05). Con-clusion The reduction of TNF-α, IL-6 may be the mechanisms involved in the therapeutic effect of ghrelin administration on severity of kidney injury in SAP.