CAJ | 학술논문

目的探讨缬沙坦对重症急性胰腺炎(SAP)时胰腺微循环的作用及其机制.方法假手术组(SO组)逆行胆胰管注射等量生理盐水；SAP组胆胰管逆行注射牛磺胆酸钠建立大鼠SAP模型；缬沙坦组(Ⅴ组)于造模后10 min股静脉注射缬沙坦.检测3、6、12h各组大鼠血清淀粉酶(AMY)和丙二醛(MDA)的水平及血液P选择素的表达,取胰头部胰腺组织行病理学检查,测定胰腺组织中血管紧张素Ⅱ(AngⅡ)和髓过氧化物酶(MPO)的水平,并检测胰腺组织细胞间黏附分子-1(ICAM-1)的表达.结果 Ⅴ组3、6、12h血清AMY表达水平分别为(3845.8±304.0)、(4462.6±412.9)、(4898.0±408.2) U/dl,血清MDA各时点分别为(3.64±0.82)、(3.79±0.71)、(3.94±1.03) μmol/L,胰腺组织MPO含量分别为(1.94±0.72)、(2.31 ±0.81)、(3.18±0.73) U/g,胰腺组织中AngⅡ含量分别为(124.33±15.72)、(162.42±18.81)、(220.28±19.73) ng/L,明显低于SAP组；3、6、12h血清AMY的表达水平分别为(6149.7±393.1)、(7401.4±578.5)、(9142.9±751.8) U/dl(P＜0.05),MDA的表达水平分别为(4.42±1.21)、(5.61±1.17)、(5.95 ± 1.12) μmol/L(P＜0.05),胰腺组织AngⅡ的含量分别为(240.90±31.46)、(273.96±27.85)、(355.72±42.77) ng/L(P＜0.05),MPO的含量分别为(3.28±0.64)、(4.62±0.87)、(5.22 ±0.75) U/g(P＜0.05)；Ⅴ组血小板P选择素表达水平(23％)及ICAM-1的表达水平明显低于SAP组(34％,P＜0.05),但都高于SO组(P＜0.05).结论 SAP时胰腺组织中AngⅡ明显增加,缬沙坦对SAP有一定的保护作用；这一保护作用可能与缬沙坦抑制MDA、MPO、ICAM-1和P选择素的表达有关.
목적 탐토힐사탄대중증급성이선염(SAP)시이선미순배적작용급기궤제.방법 가수술조(SO조)역행담이관주사등량생리염수；SAP조담이관역행주사우광담산납건립대서SAP모형；힐사탄조(Ⅴ조)우조모후10 min고정맥주사힐사탄.검측3、6、12h각조대서혈청정분매(AMY)화병이철(MDA)적수평급혈액P선택소적표체,취이두부이선조직행병이학검사,측정이선조직중혈관긴장소Ⅱ(AngⅡ)화수과양화물매(MPO)적수평,병검측이선조직세포간점부분자-1(ICAM-1)적표체.결과 Ⅴ조3、6、12h혈청AMY표체수평분별위(3845.8±304.0)、(4462.6±412.9)、(4898.0±408.2) U/dl,혈청MDA각시점분별위(3.64±0.82)、(3.79±0.71)、(3.94±1.03) μmol/L,이선조직MPO함량분별위(1.94±0.72)、(2.31 ±0.81)、(3.18±0.73) U/g,이선조직중AngⅡ함량분별위(124.33±15.72)、(162.42±18.81)、(220.28±19.73) ng/L,명현저우SAP조；3、6、12h혈청AMY적표체수평분별위(6149.7±393.1)、(7401.4±578.5)、(9142.9±751.8) U/dl(P＜0.05),MDA적표체수평분별위(4.42±1.21)、(5.61±1.17)、(5.95 ± 1.12) μmol/L(P＜0.05),이선조직AngⅡ적함량분별위(240.90±31.46)、(273.96±27.85)、(355.72±42.77) ng/L(P＜0.05),MPO적함량분별위(3.28±0.64)、(4.62±0.87)、(5.22 ±0.75) U/g(P＜0.05)；Ⅴ조혈소판P선택소표체수평(23％)급ICAM-1적표체수평명현저우SAP조(34％,P＜0.05),단도고우SO조(P＜0.05).결론 SAP시이선조직중AngⅡ명현증가,힐사탄대SAP유일정적보호작용；저일보호작용가능여힐사탄억제MDA、MPO、ICAM-1화P선택소적표체유관.
Objective To explore the effect of valsartan on pancreas microcirculation in rats with severe acute pancreatitis (SAP) and the action mechanism.Methods The SAP rats were randomly assigned to 3 groups:the control group (SO group),model group (SAP group) and valsartan-treated group (Ⅴ group).The rat model of SAP was established by retrograde injection of 5％ sodium taurocholate into the biliopancreatic duct.SO group was subjected to bile duct retrograde injection of the same amount of physiological saline,and Ⅴ group to femoral vein injection of valsartan 10 min after modeling.The changes in serum amylase (AMY),pathology,angiotensin (Ang) Ⅱ,malondialdehyde (MDA),myeloperoxidase (MPO),intercellular adhesion molecule-1 (ICAM-1),and P-selectin in pancreatic tissues were observed.Results At 3,6 and 12 h after operation in SAP group,the contents of AMY were (6149.7 ± 393.1),(7401.4 ±578.5) and (9142.9 ± 751.8) U/dl,the contents of MDA were (4.42 ± 1.21),(5.61 ±1.17) and (5.95 ± 1.12) μmol/L,and the levels of MPO were (3.28 ±0.64),(4.62 ±0.87) and (5.22 ±0.75) U/g,the contents of AngⅡ were (240.90 ±31.46),(273.96 ±27.85) and (355.72 ±42.77) ng/L,which were significantly higher than in SO group [for AMY:(3845.8 ± 304.0),(4462.6±412.9) and (4898.0 ±408.2) U/dl; for MDA:(3.64 ±0.82),(3.79 ±0.71) and (3.94±1.03) μmol/L; for MPO:(1.94±0.72),(2.31 ±0.81) and (3.18±0.73) U/g; for AngⅡ:(124.33 ±15.72),(162.42 ± 18.81) and (220.28 ± 19.73) ng/L] (all P＜0.05).The P-selectin espresssion levels (23％) and the levels of ICAM-1 in Ⅴ group were significantly lower than in SAP group (P ＜ 0.05),but higher than in SO group (P ＜ 0.05).The pancreatic injury in SAP group was aggravated as compared with Ⅴ group.Conclusion The Ang Ⅱ contents in the SAP rats were significantly increased in the pancreatic tissue.Valsartan had a protective effect on the pancreas of SAP rats probably by inhibiting the contents of MDA and MPO,and the expression levels of ICAM-1 and P-selectin.