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目的探讨肿瘤坏死因子α(TNF-α)抑制剂对重症急性胰腺炎(SAP)大鼠肾损伤的影响。方法60只SD大鼠随机分成假手术组,SAP组,TNF-α抑制剂治疗组,每组20只。各组建模48 h后处死动物并收集标本,测血清淀粉酶,TNF-α,尿素氮和肌酐;应用TUNEL法检测肾细胞凋亡,计算凋亡指数(AI);并用免疫组化法检测肾脏组织NF-κB的表达,RT-PCR检测ET-1 mRNA的表达。结果假手术组的各项指标均低于SAP组和治疗组(P<0.05)。SAP组TNF-α,血清淀粉酶,尿素氮,肌酐和NF-κB IOD水平分别为(185.36±10.95)ng/L,(7 257.30±361.20)U/L,(17.28±0.87)mmol/L,(78.83±3.02)μmol/L和316.25±20.90,治疗组以上指标分别为(124.32±15.11)ng/L,(6182.60±291.63)U/L,(13.66±0.88)mmol/L,(68.68±3.38)μmol/L和241.90±19.04,两组间比较差异有统计学意义(P<0.05)。SAP组AI为3.33±0.49,明显低于治疗组的7.04±0.41(P<0.05)。SAP组中ET-1 mRNA水平明显高于治疗组和假手术组(P<0.05)。结论TNF-α抑制剂可促进大鼠肾脏细胞凋亡,减轻炎症反应对肾的损伤,改善肾脏功能。
Objective To investigate the effect of tumor necrosis factor α (TNF-α) inhibitor on renal injury in rats with severe acute pancreatitis (SAP). Methods Sixty SD rats were randomly divided into sham operation group, SAP group and TNF-α inhibitor treatment group, 20 rats in each group. The rats in each group were sacrificed 48 hours later and the specimens were collected for the determination of serum amylase, TNF-α, urea nitrogen and creatinine. The apoptosis of renal cells was detected by TUNEL method and the apoptosis index (AI) was calculated. The expression of NF-κB in renal tissue and the expression of ET-1 mRNA were detected by RT-PCR. Results The indexes of sham operation group were lower than those of SAP group and treatment group (P <0.05). The levels of TNF-α, serum amylase, urea nitrogen, creatinine and NF-κB IOD in SAP group were (185.36 ± 10.95) ng / L, (7.257.30 ± 361.20) U / L and (17.28 ± 0.87) mmol / L, (78.83 ± 3.02) μmol / L and 316.25 ± 20.90, respectively. The above indexes in the treatment group were (124.32 ± 15.11) ng / L, (6182.60 ± 291.63) U / L and (13.66 ± 0.88) mmol / L respectively ) μmol / L and 241.90 ± 19.04, the difference between the two groups was statistically significant (P <0.05). AI in SAP group was 3.33 ± 0.49, which was significantly lower than 7.04 ± 0.41 in treatment group (P <0.05). The level of ET-1 mRNA in SAP group was significantly higher than that in the treatment group and sham operation group (P <0.05). Conclusion TNF-α inhibitors can promote renal cell apoptosis, reduce the inflammatory response to renal damage and improve renal function.