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目的观察重症急性胰腺炎(SAP)血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL- 6)、血清钙和甲状旁腺激素受体(PTHR)的表达水平及相互关系,探讨甲强龙干预后的变化。方法将SD大鼠36只随机分为3组,假手术组(SO)、SAP组、SAP甲强龙治疗组(SAP+MP)各12只, 以5％牛磺脱氧胆酸钠逆行胰胆管注射建立SAP模型,观察各组血清钙、淀粉酶、TNF-α、IL-6、腹水量和胰腺病理改变,逆转录-聚合酶链反应(RT-PCR)分析肾脏和骨组织PTHR mRNA表达水平。结果 SAP组制模后血清TNF-α、IL-6升高,而肾脏和骨PTHR mRNA表达下调(P<0．01),血清钙显著降低,以12 h最为明显;血清TNF-α、IL-6与血清钙、肾脏和骨PTHR mRNA表达水平呈负相关。与SAP组比较,SAP+MP组血清TNF-α、IL-6水平明显下降,而PTHR mRNA表达上调 (P<0．01),低钙血症和胰腺局部的病理改变得到改善,存活率显著提高。结论肾脏和骨组织 PTHR mRNA表达下调是SAP低钙血症的重要原因之一,可能与炎症细胞因子的过度释放有关。甲强龙可抑制炎症细胞因子的释放,提高PTHR mRNA表达水平,改善低钙血症。
Objective To observe the expression of serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), serum calcium and parathyroid hormone receptor (PTHR) in severe acute pancreatitis , To explore the changes after the intervention of methylprednisolone. Methods Thirty-six SD rats were randomly divided into three groups: sham operation group (SO), SAP group and SAP methylprednisolone group (SAP + MP) The levels of PTHR mRNA in renal and bone tissues were determined by reverse transcription-polymerase chain reaction (RT-PCR). The levels of serum calcium, amylase, TNF-α, IL-6, . Results Serum levels of TNF-α and IL-6 in SAP group were significantly increased (P <0.01), and serum calcium was significantly decreased at 12 h -6 was negatively correlated with PTHR mRNA expression in serum calcium, kidney and bone. Compared with the SAP group, the levels of TNF-α and IL-6 in SAP + MP group were significantly decreased, while PTHR mRNA expression was increased (P <0.01), the pathological changes of hypocalcemia and pancreas were improved, and the survival rate was significantly improve. Conclusions The down-regulation of PTHR mRNA expression in kidney and bone is one of the important causes of SAP hypocalcemia, which may be related to the excessive release of inflammatory cytokines. Methylprednisolone can inhibit the release of inflammatory cytokines, increase the expression of PTHR mRNA, improve hypocalcemia.