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目的本实验旨在通过动态观察重症急性胰腺炎小肠组织中多种细胞因子,包括:肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)、白细胞介素10(IL-10)、细胞间黏附因子1(ICAM-1)mRNA的变化,探讨乌司他丁(ulinas-tatin,UT)对炎性细胞因子的下调作用,及其对肠粘膜屏障的保护作用。方法SD大鼠40只,随机分成4组,即正常组(10只)、假手术组(SO)(10只)、SAP组(10只)、SAP+UT组(10只),建立假手术组、重症急性胰腺炎及治疗组模型。术后3h、6h、12h、24h应用逆转录聚合酶链反应(RT-PCR)检测TNF-α、IL-6、IL-10、CAM-1mRNA的表达,以及相应时段小肠组织NF-κB及血液中DAO的表达。结果SAP组大鼠肠黏膜TNF-α、IL-6、IL-10、ICAM-1mRNA表达较SO组增高,其中TNF-αmRNA表达于术后6h达峰值,ICAM-1表达于术后12h达峰值,IL-6、IL-10术后6小时表达增加,且随着时间的延长表达量增加,UT治疗组TNFα、IL-6、IL-10和ICAM-1表达均显著下调P<0.05。SO组大鼠肠黏膜少见NF-κB活化的细胞,而SAP组大鼠术后3h肠黏膜即出现大量核内NF-κB染色阳性细胞,UT治疗组肠黏膜NF-κB活化细胞明显少于SAP组。结论乌司他丁可以显著降低SAP组大鼠小肠NF-κB的表达以及细胞因子mRNA的表达,抑制炎症反应,从而起到保护肠黏膜屏障的作用。
OBJECTIVE: The purpose of this study was to investigate the expression of TNF-α, IL-6, IL-10 and IL-6 in intestinal tissue of patients with severe acute pancreatitis , Intercellular adhesion molecule 1 (ICAM-1) mRNA, to investigate the down-regulation of inflammatory cytokines by ulinas-tatin (UT) and its protective effect on intestinal mucosal barrier. Methods Forty Sprague Dawley rats were randomly divided into 4 groups: normal group (10 rats), sham operation group (10 rats), SAP group (10 rats) and SAP + UT group (10 rats) Group, severe acute pancreatitis and treatment group model. The expression of TNF-α, IL-6, IL-10 and CAM-1 mRNA were detected by reverse transcription polymerase chain reaction (RT-PCR) at 3h, 6h, 12h and 24h after operation and the expressions of NF- In DAO expression. Results The expression of TNF-α, IL-6, IL-10 and ICAM-1 mRNA in SAP group were significantly higher than those in SO group. The expression of TNF-α mRNA reached the peak at 6 hours after operation and the ICAM-1 expression peaked at 12 hours The expression of IL-6 and IL-10 increased 6 hours after operation, and the expression of IL-6 and IL-10 increased with time. The expressions of TNFα, IL-6, IL-10 and ICAM-1 in UT group were significantly decreased. The number of NF-κB positive cells in the intestinal mucosa of SAP group was significantly higher than that in SAP group (P <0.05), and the number of activated NF-κB in intestinal mucosa of UT group was significantly less than that of SAP group group. Conclusion Ulinastatin can significantly reduce the expression of NF-κB and cytokine mRNA in the small intestine of SAP group, and inhibit the inflammatory reaction, which can protect the intestinal mucosal barrier.