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目的探讨清除腹腔巨噬细胞(peritoneal macrophages,PMs)对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠肠道屏障功能的影响。方法 36只SD大鼠随机分为PMs保留组、PMs清除组和假手术组,每组12只。PMs保留组与PMs清除组经胆胰管逆行注射质量分数2%去氧胆酸钠建立大鼠SAP模型,假手术组注射生理盐水。PMs清除组分别于造模前5d、前2d腹腔注射氯屈磷酸二钠脂质体清除PMs,PMs保留组与假手术组同样时间注射等量空脂质体。检测3组血清淀粉酶及血浆D-乳酸水平,比较胰腺病理评分、肠道转运系数及脏器细菌移位率。结果 PMs保留组与PMs清除组血清淀粉酶水平((9 399±923)、(9 012±852)u/L)高于假手术组((1 367±360)u/L)(P<0.01),PMs保留组与PMs清除组比较差异无统计学意义(P>0.05);假手术组大鼠肠道转运系数(0.46±0.12)高于PMs清除组(0.33±0.10)与PMs保留组(0.23±0.09)(P<0.01),PMs清除组高于PMs保留组(P<0.05);假手术组大鼠脏器细菌移位率((5.60±0.68)%)、血浆D-乳酸水平((5.66±0.43)mg/L)低于PMs清除组(40.55±5.67)%,(8.96±0.67)mg/L)与PMs保留组((51.63±7.53)%,(12.62±0.89)mg/L))(P<0.01),PMs清除组低于PMs保留组(P<0.05);PMs清除组胰腺病理评分(7.9±1.2)与PMs保留组(7.6±0.9)比较差异无统计学意义(P>0.05)。结论造模前PMs消耗对SAP大鼠肠道屏障功能有保护作用。
Objective To investigate the effect of removing peritoneal macrophages (PMs) on the intestinal barrier function in rats with severe acute pancreatitis (SAP). Methods Thirty - six SD rats were randomly divided into PMs retention group, PMs removal group and sham operation group, with 12 rats in each group. PMs retention group and PMs clearance group were transcatheter biliary and pancreatic duct retrograde injection of 2% sodium deoxycholate rat model of SAP, sham operation group injected with saline. The PMs were removed 5 days before and 2 days before injection respectively. PMs were injected intraperitoneally into the PMs clearance group. The same amount of empty liposomes were injected into the PMs-preserved and sham-operated groups at the same time. Serum amylase and plasma D-lactate levels were measured in 3 groups. Pancreatic pathological score, intestinal transit coefficient and organ bacterial translocation rate were compared. Results Serum amylase levels in the PMs group and the PMs group were significantly higher than those in the sham group (9 399 ± 923 and 9 012 ± 852 u / L, respectively, P <0.01 (P> 0.05). The intestinal transport coefficient (0.46 ± 0.12) in sham operation group was significantly higher than that in PMs clearance group (0.33 ± 0.10) and PMs retention group ( 0.23 ± 0.09) (P <0.01), the PMs clearance group was higher than the PMs retention group (P <0.05); the bacterial translocation rate (5.60 ± 0.68)%, plasma D-lactate level (5.66 ± 0.43) mg / L was lower than that of the PMs group (40.55 ± 5.67)%, (8.96 ± 0.67) mg / L and (52.63 ± 7.53)% and ) (P <0.01). The PMs clearance group was lower than the PMs retention group (P <0.05). There was no significant difference between the PMs clearance group (7.9 ± 1.2) and the PMs retention group (7.6 ± 0.9) > 0.05). Conclusion Consumption of PMs before model establishment has a protective effect on intestinal barrier function in SAP rats.