CAJ | 학술논문

目的：探讨内皮素受体阻断对重症急性胰腺炎病情及炎症反应的影响，为内皮素拮抗剂的临床应用提供实验依据。方法60只 SD 大鼠随机分为对照组（n ＝12）、模型组（n ＝24）以及观察组（n ＝24），对照组腹腔注射生理盐水，模型组和观察组腹腔注射雨蛙素建立重症急性胰腺炎模型，观察组于造模4 h 后静脉注射内皮素受体拮抗剂 BQ123，其余两组注射生理盐水。观察各组胰腺、肺组织病理改变，同时对各组血清淀粉酶、尿素氮、谷丙转氨酶以及肌酸激酶等生化指标，血清内皮素及炎症因子肿瘤坏死因子-α（TNF -α）、白细胞介素（IL）-6、IL -1、IL -10水平及胰腺 NF -κB 信号通路磷酸化 IκBα表达量进行测定。结果模型组各时间点胰腺、肺组织病理评分，血清淀粉酶、尿素氮、肌酸激酶、谷草转氨酶水平，血清炎症因子 TNF -α、IL -6、IL -1、IL -10水平及胰腺磷酸化 IκBα表达量均显著高于对照组（P ＜0.05），而观察组各时间点上述指标均较模型显著降低（P ＜0.05）。结论内皮素受体阻断有助于改善急性胰腺炎机体内的微循环障碍，减少胰腺及胰外器官的损伤，有助于降低对NF -κB 信号通路的刺激，从而减轻疾病的炎症反应，阻止疾病的进一步发展。
목적：탐토내피소수체조단대중증급성이선염병정급염증반응적영향，위내피소길항제적림상응용제공실험의거。방법60지 SD 대서수궤분위대조조（n ＝12）、모형조（n ＝24）이급관찰조（n ＝24），대조조복강주사생리염수，모형조화관찰조복강주사우와소건립중증급성이선염모형，관찰조우조모4 h 후정맥주사내피소수체길항제 BQ123，기여량조주사생리염수。관찰각조이선、폐조직병리개변，동시대각조혈청정분매、뇨소담、곡병전안매이급기산격매등생화지표，혈청내피소급염증인자종류배사인자-α（TNF -α）、백세포개소（IL）-6、IL -1、IL -10수평급이선 NF -κB 신호통로린산화 IκBα표체량진행측정。결과모형조각시간점이선、폐조직병리평분，혈청정분매、뇨소담、기산격매、곡초전안매수평，혈청염증인자 TNF -α、IL -6、IL -1、IL -10수평급이선린산화 IκBα표체량균현저고우대조조（P ＜0.05），이관찰조각시간점상술지표균교모형현저강저（P ＜0.05）。결론내피소수체조단유조우개선급성이선염궤체내적미순배장애，감소이선급이외기관적손상，유조우강저대NF -κB 신호통로적자격，종이감경질병적염증반응，조지질병적진일보발전。
Objective To investigate the effects of endothelin receptor blockade on severe acute pancreatitis (SAP)and inflammatory responses,thus to provide experimental basis for clinical application of endothelin antagonists. Methods Sixty male SD rats were randomly divided into control group(n = 12),SAP group(n = 24)and BQ123 group (n = 24). Normal saline was injected into control group,while caerulein was injected into subjects in SAP group and BQ123 group to build SAP models. The endothelin receptor antagonist BQ123 was injected into BQ123 group 4 hours after modeling,while replaced normal saline was given to the other two groups instead. The pathological changes of pancrea and lung,the serum amylase,blood urea nitrogen,creatine kinase,alanine aminotransferase,serum endothelin,inflammatory cytokines TNF - α,IL - 6,IL - 1,IL - 10 and pancreatic NF - κB signaling factors(IκBα of phosphorylation expres-sion)were determined. Results Significant elevation in pancreas and lung pathology scores,serum amylase,blood urea nitrogen,creatine kinase,alanine aminotransferase levels,serum inflammatory cytokine TNF - α,IL - 6,IL - 1,IL - 10 levels,and phosphorylated pancreatic IκBα were observed in SAP group than those in control group(P < 0. 05);which were significantly alleviated by BQ123. Conclusion The blocking of endothelin receptor in acute pancreatitis helps to im-prove microcirculation,reduce the damage of the pancrea and the other organs,and reduce stimulation of the NF - κB sig-naling pathway and the inflammatory response,thus prevent development of the pancreatitis.