重症急性胰腺炎时胰腺组织细胞凋亡与病变严重程度的关系

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目的探讨实验性重症急性胰腺炎(SAP)胰腺组织细胞凋亡与胰腺病变严重程度的关系。方法28只SD大鼠随机分为两组:对照组7只、SAP组21只。牛磺胆酸钠诱导SD大鼠SAP模型,于造模成功后3、6、12 h分别处死7只。检测血清淀粉酶浓度、胰腺组织学损伤评分(HI),TUNEL法检测胰腺组织细胞凋亡指数(AI)、免疫组化法检测Fas/FasL表达。结果12 h时SAP组大鼠死亡1只,对照组无死亡。SAP组的血清淀粉酶浓度(U/L)在3 h、6 h、12 h时分别为3904±737、6133±882、10 606±2 641(对照组1 518±562,P=0.000),相应时点的H1分别是4.85±1.35、8.14±1.34、11.00±1.26(对照组为1.57±0.79,P=0.000),各组间差异有显著统计学意义。对应时间点的胰腺AI分别是1.200±0.497、0.886±0.389和0.700_±0.352(对照组为1.028±0.403,),12 h与3 h的差异有统计学意义(P=0.047)。Fas的表达强度分别为108.00±10.02、93.14±8.17、73.33±9.52(对照组为102.00±13.24,P=0.001),FasL分别为83.86±31.13、79.57±9.78、73.33±15.79 (对照组为88.57±7.68,P=0.023)。SAP组AI与HI(r=-0.510,P=0.022)、AI与AMY(r=- 0.471,P=0.036)分别呈负相关关系,Fas与AI(r=0.572,P=0.008)呈正相关关系。结论在实验性SAP大鼠中,胰腺组织细胞凋亡指数与胰腺组织学损伤程度呈负相关,诱导凋亡可能减轻胰腺炎的进展有关。 Objective To investigate the relationship between the apoptosis of pancreas and the severity of pancreatic lesions in experimental severe acute pancreatitis (SAP). Methods Twenty-eight SD rats were randomly divided into two groups: control group (n = 7) and SAP group (n = 21). Sodium taurocholate induced SAP model in SD rats, and 7 rats were sacrificed 3, 6 and 12 h after successful modeling. Serum amylase concentration, pancreatic histological injury score (HI), pancreatic apoptosis index (AI) by TUNEL method and Fas / FasL expression by immunohistochemistry. Results At 12 h, one SAP died in the control group and none died in the control group. Serum amylase concentration (U / L) in SAP group was 3904 ± 737, 6133 ± 882 and 10 606 ± 2 641 at 3 h, 6 h and 12 h (control group 1 518 ± 562, P = 0.000) The corresponding H1 time points were 4.85 ± 1.35, 8.14 ± 1.34 and 11.00 ± 1.26 respectively (control group, 1.57 ± 0.79, P = 0.000). The differences among the groups were statistically significant. The corresponding time point of pancreatic AI was 1.200 ± 0.497,0.886 ± 0.389 and 0.700 ± 0.352 (control group 1.028 ± 0.403, respectively), 12 h and 3 h was statistically significant difference (P = 0.047). The expression of Fas was 108.00 ± 10.02,93.14 ± 8.17 and 73.33 ± 9.52 respectively (control group was 102.00 ± 13.24, P = 0.001), and FasL was 83.86 ± 31.13,79.57 ± 9.78 and 73.33 ± 15.79 respectively (88.57 ± 7.68, P = 0.023). There was a negative correlation between AI and HI (r = -0.510, P = 0.022), AI and AMY (r = - 0.471, P = 0.036) . Conclusion In experimental SAP rats, the apoptosis index of pancreatic tissue is negatively correlated with the extent of pancreatic histological damage, and inducing apoptosis may reduce the progression of pancreatitis.
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