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为研究肿瘤坏死因子（ＴＮＦ）在急性坏死性胰腺炎（ＡＮＰ）所致肺损害中的作用，１４只家犬随机分成三组。中药组（ｎ＝５）：ＡＮＰ模型＋大承气汤治疗；盐水组（ｎ＝５）：ＡＮＰ模型＋生理盐水治疗；假手术组（ｎ＝４）。术后测定血清、支气管肺泡灌洗液（ＢＡＬＦ）的ＴＮＦ活性及血清内毒素水平等指标。结果：１．ＢＡＬＦ中ＴＮＦ活性升高较血清中升高更明显。２．中药组术后６、１２小时血清及ＢＡＬＦ中ＴＮＦ活性低于盐水组（Ｐ＜０．０１）。３．术后１２小时中药组肺损害程度明显轻于盐水组。４．盐水组血清ＴＮＦ活性与内毒素水平呈正相关（Ｐ＜０．０５）。结论：ＴＮＦ的过度分泌是ＡＮＰ致肺损害的重要因素；通里攻下法治疗能够减轻ＴＮＦ介导的肺损害程度。
To investigate the role of tumor necrosis factor (TNF) in lung injury induced by acute necrotizing pancreatitis (ANP), 14 dogs were randomly divided into three groups. Chinese medicine group (n = 5): ANP model + Dachengqi decoction; saline group (n = 5): ANP model + saline treatment; sham operation group (n = 4). The levels of TNF and serum endotoxin in serum and bronchoalveolar lavage fluid (BALF) were measured after operation. Results: 1. Increased TNF activity in BALF is more pronounced than in serum. 2. The activity of TNF in serum and BALF of Chinese medicine group was lower than that of saline group at 6 and 12 hours after operation (P <0.01). 3. At 12 hours after operation, the degree of lung damage in Chinese medicine group was significantly lower than that in saline group. 4. Serum TNF activity in saline group was positively correlated with endotoxin level (P <0.05). CONCLUSIONS: The excessive secretion of TNF is an important factor of ANP-induced lung damage. Tonglian attack treatment can reduce the extent of TNF-mediated lung injury.