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目的探讨重症急性胰腺炎(SAP)时胰腺组织的诱导型一氧化氮合成酶(iNOS)、内皮素(ET-1)mRNA表达状态,以及与血浆中NO、ET-1浓度和肠道损伤的关系及丹参治疗的影响。方法Wistar大鼠45只随机分为3组:SAP模型组(A组),SAP丹参治疗组(B组),假手术组(C组),进行不同治疗和观察分析。结果A组血中淀粉酶(AML)、ET-1、NO、内毒素(LPS)含量、125I-白蛋白累积指数及腹水量均显著高于C组(P<0.01);与A组比较,B组胰腺ET-1和iNOSmRNA表达较弱,血中AML、ET-1、NO、LPS及腹水量显著下降(P<0.01),125I-白蛋白累积指数较A组也有下降,但无差异(P>0.05)。结论SAP时存在肠道损伤,胰腺组织ET-1、iNOSmRNA的过度表达,使血中ET-1、NO浓度升高,造成肠道屏障功能受损,肠通透性增加,引起内毒素血症。丹参注射液通过减轻SAP时胰腺的病理损害程度,下调胰腺ET-1和iNOSmRNA的表达,使血中ET-1、NO浓度下降,对SAP及其肠道损伤有一定治疗作用。
Objective To investigate the expression of inducible nitric oxide synthase (iNOS) and endothelin (ET-1) mRNA in pancreatic tissues of patients with severe acute pancreatitis (SAP) and the correlations with the levels of NO, ET-1 and intestinal injury Relationship and Salvia treatment effects. Methods Forty-five Wistar rats were randomly divided into three groups: SAP model group (A group), SAP group (B group) and sham operation group (C group). Results The levels of amylase (AML), ET-1, NO, LPS, 125I-albumin index and ascites in group A were significantly higher than those in group C (P <0.01) The expression of ET-1 and iNOS mRNA in pancreas of group B was weaker than that of group A, while the levels of AML, ET-1, NO, LPS and ascites in group B were significantly decreased (P <0.01) P> 0.05). Conclusions There is intestinal injury in SAP. The overexpression of ET-1 and iNOS mRNA in pancreas leads to the increase of ET-1 and NO in blood, resulting in impaired intestinal barrier function and increased intestinal permeability, resulting in endotoxemia . Salvia miltiorrhiza injection can reduce the concentration of ET-1 and NO in the blood and relieve the damage of SAP and its intestinal tract by reducing the degree of pancreatic pathological damage, decreasing the expression of ET-1 and iNOS mRNA in the pancreas.