CAJ | 학술논문

目的观察不同海拔大鼠血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL-10)在重症急性胰腺炎(SAP)中的表达水平及其与胰腺组织病理变化之间的关系,为临床诊断和治疗SAP提供实验依据.方法 72只SPF级健康雄性Wistar大鼠随机分为海拔1 500米(L)组、海拔3 300米(M)组、海拔4 300米(H)组.每组随机分成假手术组、造模6h、12 h、24 h组.造模组行胰胆管逆行注射5％牛磺胆酸钠建立SAP模型,假手术组仅打开腹腔翻动胰腺数次.造模组分别在造模后第6、12、24小时分批随机处死大鼠,假手术组在6h处死大鼠.所有大鼠处死后均采集血清及胰腺组织.ELISA法测定血清TNF-α、IL-10含量;胰腺损害程度采用病理评分评价.结果与假手术组比较,同一海拔内造模组各时点胰腺病理评分、IL-10、TNF-α差异均有统计学意义(P＜0.05).同一海拔内造模组胰腺病理评分、IL-10的表达随着时点的延长而增加,TNF-α随时点的延长而减少.造模组同一时点L组与M组、L组与H组比较,胰腺病理评分、TNF-α和IL-10差异有统计学意义(P＜0.05),H组与M组比较差异无统计学意义(P＞0.05).IL-10与胰腺病理评分呈正相关,TNF-α与胰腺病理评分呈负相关.结论在SAP时,TNF-α水平随海拔增高而增高,但随时点延长显著降低,IL-10水平随海拔增高和时间延长而持续上升,提示二者在不同时段对SAP的发生发展起着重要作用.
목적 관찰불동해발대서혈청종류배사인자α(TNF-α)、백세포개소(IL-10)재중증급성이선염(SAP)중적표체수평급기여이선조직병리변화지간적관계,위림상진단화치료SAP제공실험의거.방법 72지SPF급건강웅성Wistar대서수궤분위해발1 500미(L)조、해발3 300미(M)조、해발4 300미(H)조.매조수궤분성가수술조、조모6h、12 h、24 h조.조모조행이담관역행주사5％우광담산납건립SAP모형,가수술조부타개복강번동이선수차.조모조분별재조모후제6、12、24소시분비수궤처사대서,가수술조재6h처사대서.소유대서처사후균채집혈청급이선조직.ELISA법측정혈청TNF-α、IL-10함량;이선손해정도채용병리평분평개.결과 여가수술조비교,동일해발내조모조각시점이선병리평분、IL-10、TNF-α차이균유통계학의의(P＜0.05).동일해발내조모조이선병리평분、IL-10적표체수착시점적연장이증가,TNF-α수시점적연장이감소.조모조동일시점L조여M조、L조여H조비교,이선병리평분、TNF-α화IL-10차이유통계학의의(P＜0.05),H조여M조비교차이무통계학의의(P＞0.05).IL-10여이선병리평분정정상관,TNF-α여이선병리평분정부상관.결론 재SAP시,TNF-α수평수해발증고이증고,단수시점연장현저강저,IL-10수평수해발증고화시간연장이지속상승,제시이자재불동시단대SAP적발생발전기착중요작용.
Objective To observed the expression of serum TNF-α and IL-10 in rats with severe acute pancreatitis (SAP) at different altitudes,and to explore the relationships between TNF-α and IL-10,the pathological changes of the pancreas,and the experimental basis for clinical diagnosis and treatment of SAP.Methods 72 specific pathogen free (SPF) Wistar male rats were divided randomly into three groups:1 500 meters altitude (group L),3 300 meters altitude (group M),and 4 300 meters altitude (group H).These three groups were then each divided randomly into four subgroups:control (group n),6 hours after pancreatitis (group p 6 h),12 hours after pancreatitis (group p 12 h),and 24 hours after pancreatitis (group p 24 h).Pancreatitis was induced by intraductal administration of 5％ sodium taurocholate hydrate (NaTc).The rats were killed at 6,12,and 24 hours after NaTc injection in groups p.The group n rats were killed after 6 hours of pancreas observation.Blood samples and pancreatic tissues were collected post mortem and enzyme-linked immunosorbent assay (ELISA) measured serum TNF-α and IL-10.Results Compared with the control (group n),histopathological scores,IL-10,and TNF-α in the same altitude had a significant difference (P ＜ 0.05) in group p at each time point.In the same altitude of group p,histopathological scores and IL-10 were increased with time elapsed (P ＜ 0.05),while TNF-α was decreased with time elapsed (P ＜ 0.05).There was a significant difference between group Mp and Lp in histopathological scores,IL-10,and TNF-α (P ＜ 0.05),and the same result between group Hp and Lp (P ＜ 0.05),but there was no significant difference between group Hp and Mp (P ＜ 0.05).Meanwhile,IL-10 had a positive relationship with histopathological score,but TNF-α had a negative relationship with histopathological score.Conclusions The level of TNF-α increased with increasing altitude but significantly reduced with elapsed time.The level of IL-10 increased with both increasing altitude elapsed time.These results suggested that TNF-o and IL-10 might play a important role at different times in severe acute pancreatitis.