【摘要】 目的 探讨血必净对大鼠急性胰腺炎的保护作用及机制。方法 SD大鼠48只, 随机分为假手术组、胰腺炎组和治疗组,每组再分为4 h、8 h亚组。假手术组仅行开关腹手术,胰腺炎组以牛磺胆酸钠造模,治疗组以血必净干预。光镜观察胰腺组织病理改变,免疫组化法测胰腺组织肿瘤坏死因子(TNF)-、干扰素(IL)-1。结果 治疗组胰腺组织损伤较胰腺炎组明显减轻,治疗组胰腺组织中TNF-、IL-1含量显著低于胰腺炎组 (P0.01)。结论 血必净可能通过抑制TNF-、IL-1的产生减轻胰腺炎症。
【关键词】 血必净;胰腺炎;肿瘤坏死因子;干扰素
Abstract: Objective To investigate the protective effect of Xuebijing (XBJ) on acute pancreatitis in rats and its possible mechanism. Methods 48 SD rats were randomized into 3 groups: sham group, pancreatitis group and XBJ group, each group sub-divided into 4h and 8h subgroups. In the sham groups, the rats only underwent opening and closure of the abdomen; the pancreatitis groups received taurocholate sodium administration to establish animal model and the treatment groups were intervened by Xuebijing. The pathologic changes of pancreatic tissues were observed by optic microscopy. The expressions of tumor necrosis factor (TNF)- and interleukin (IL)-1 in pancreatic tissues were determined by immunohistochemical methods. Results The histomorphological changes of the pancreatic tissues in XBJ group were much more relieved than those in the pancreatitis group. The expressions of TNF- and IL-1 were significantly lower in XBJ group than those in the pancreatitis group (P0.01). Conclusion XBJ could relieve acute pancreatitis in rats by inhibiting the production of TNF- and IL-1.
Key words: Xuebijing; pancreatitis; tumor necrosis factor-; interleukin-1
1 材料和方法
1.3 TNF-、IL-1表达检测 免疫组化染色法(试剂盒均购自武汉博士德生物工程有限公司)测胰腺组织TNF-、IL-1表达,结果应用计算机进行图像灰度分析,以积分光密度值(D)作计量分析,每张片选4个视野。
2 结 果
2.1 组织病理学结果 假手术组胰腺组织肉眼及镜下结构无明显异常。胰腺炎组肉眼观胰腺明显肿胀,伴有出血坏死;镜下见间质血管扩张、淤血,灶状胰腺腺泡与脂肪坏死,大量炎性细胞浸润,红细胞渗出,胰腺细胞结构消失。治疗组肉眼病变及镜下观察组织结构破坏明显减轻。
3 讨 论
急性胰腺炎大鼠胰腺腺泡细胞、血管内皮细胞、胰岛细胞均能产生TNF-及IL-1,两者均是重要的炎症介质,在急性胰腺炎的发病及其全身并发症发生过程中起着重要作用,被作为急性胰腺炎发病后反映其严重程度的重要的早期指标[3]。两者具有趋化性,能促进中性粒细胞的释放,诱导单核细胞和多核粒细胞趋化浸润到炎症局部,并且进一步促进TNF-和IL-1的释放,形成一种恶性循环。
血必净注射液是在菌、毒、炎并治的理论指导下研制而成的水溶性溶液,因其在防治脓毒症和多器官功能障碍综合征(MODS)方面取得的显著疗效而受到重视。其主要成分有川芎、赤芍、丹参、红花等,具有扩张血管,改善微循环与组织灌注,抑制血小板聚集,促进纤维组织重吸收、胶原纤维的降解及保护血管内皮细胞等作用,能抑制炎性介质的过度释放,从而有效地减少损伤因子对机体的损伤[1,4]。
本实验结果显示:胰腺炎组TNF-、IL-1表达较假手术组明显增加(P0.01),差异有统计学意义,说明TNF-、IL-1与急性胰腺炎发病有密切关系;治疗组胰腺组织病理损伤变化较胰腺炎组明显减轻,说明血必净对急性胰腺炎有治疗作用;同时治疗组TNF-、IL-1表达较胰腺炎组明显减少(P0.01),这一结果提示血必净注射液可能通过减少TNF-、IL-1等炎性因子的产生,从而阻断了炎症介质的瀑布样级联反应,抑制了炎症反应,从而减轻了胰腺损伤。
血必净抑制TNF-、IL-1的产生的具体过程有待进一步研究,同时血必净对急性胰腺炎的治疗作用的机制可能是多方面的。
【参考文献】
[4] 邢柏,曾琦,王日兴,等. 血必净对急性胰腺炎相关性肾损伤的预防和治疗作用[J].中国急救医学,2008,28(8):683-685.
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