發(fā)布時(shí)間：2018-03-26 18:12

  本文選題：重癥急性胰腺炎　切入點(diǎn)：腸道免疫屏障　出處：《皖南醫(yī)學(xué)院》2016年碩士論文

【摘要】：目的:建立大鼠重癥急性胰腺炎(SAP)模型,動(dòng)態(tài)的觀察SAP大鼠胰腺、腸組織病理、血清TNF-α、IL-6濃度變化,以及小腸組織勻漿TNF-α、IL-6和小腸粘液SIgA變化,進(jìn)一步探討SAP時(shí)炎癥因子的變化以及腸道局部炎癥因子與腸道粘膜屏障的關(guān)系。方法:48只健康成年雄性SD大鼠,體重250±30g,隨機(jī)分成2組:假手術(shù)組(A組,N=24)、SAP組(B組,N=24)各組再按術(shù)后6、12、24h小時(shí)時(shí)段隨機(jī)分為3個(gè)小組。每個(gè)時(shí)間點(diǎn)8只。實(shí)驗(yàn)前各組大鼠均禁食12h,可自由飲水。SAP組:以5%�；悄懰徕c(0.1ml/100g)逆行胰膽管注射,誘導(dǎo)SAP模型;A組:開腹后以生理鹽水(0.1ml/100g體重)逆行胰膽管注射,術(shù)后于大鼠大腿根部皮下注射0.9%氯化鈉溶液2ml/kg,以補(bǔ)充丟失液體,大鼠仍然禁食,清醒后可自由飲水。各組24只大鼠分6h,12h,24h三個(gè)時(shí)間點(diǎn),每個(gè)時(shí)間點(diǎn)8只開腹檢驗(yàn)。肉眼觀察胰腺和腸大體改變,腹主動(dòng)脈采集血液標(biāo)本5ml,離心后取血清,血清樣本保存于-20℃,以備后續(xù)檢測(cè)用,生化自動(dòng)分析儀法檢測(cè)血清淀粉酶,并采用ELISA法測(cè)定血清TNF-α、IL-6等細(xì)胞因子以及小腸組織勻漿TNF-α、IL-6、小腸粘液SIgA,制作胰腺和回腸組織標(biāo)本,HE染色用于胰腺和回腸組織損傷的病理學(xué)評(píng)價(jià),實(shí)驗(yàn)所得數(shù)據(jù)利用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1、SAP組與假手術(shù)組比較各時(shí)間點(diǎn)(術(shù)后6h、12h、24h)血清AMY、IL-6、TNF-α水平顯著升高(P0.01)。2、SAP組各時(shí)間點(diǎn)胰腺和回腸組織病理學(xué)評(píng)分較假手術(shù)組均升高(P0.01),且SAP組胰腺和回腸組織病理學(xué)評(píng)分隨時(shí)間延長而增加。3、SAP組大鼠各時(shí)間點(diǎn)小腸粘液SIgA低于假手術(shù)組。4、SAP組與假手術(shù)組相比較,隨造模時(shí)間的延長,小腸黏液SIgA濃度降低,小腸組織勻漿IL-6、TNF-α水平及小腸組織病理學(xué)評(píng)分升高(P0.01)。5、小腸組織勻漿TNF—α、IL-6濃度與小腸黏液SIgA之間具有明顯的負(fù)相關(guān)(P0.01),與小腸組織病理學(xué)評(píng)分具有明顯的正相關(guān)(P0.0 1)。結(jié)論:1、采用逆行性胰膽管注射5%�；悄懰徕c可成功制備大鼠重癥急性胰腺炎模型,此實(shí)驗(yàn)方法較穩(wěn)定,重復(fù)性好。2、SAP時(shí)細(xì)胞因子TNF-α和IL-6參與了SAP的發(fā)生和發(fā)展,TNF-α和IL-6水平的高低可能作為胰腺炎預(yù)后的預(yù)測(cè)指標(biāo)。3、SAP大鼠早期即可發(fā)生腸黏膜屏障功能障礙,免疫屏障受損,表現(xiàn)為SIgA下降。4、SAP造成胰腺損傷的同時(shí)破壞腸道粘膜免疫屏障,隨著時(shí)間的延長損傷加重,其表現(xiàn)為腸粘液SIgA減少,腸道局部炎癥因子TNF-α、IL-6增加。
[Abstract]:Objective: to establish a rat model of severe acute pancreatitis (SAP) and observe dynamically the changes of pancreatic and intestinal histopathology, serum TNF- 偽 IL-6 concentration, small intestinal homogenate TNF- 偽 IL-6 and intestinal mucus SIgA in SAP rats. To further investigate the changes of inflammatory factors during SAP and the relationship between intestinal inflammatory factors and intestinal mucosal barrier. Weight 250 鹵30g, randomly divided into two groups: sham operation group A group A group A group SAP group B group (n = 24). Each group was randomly divided into three groups according to 612h 24 hours after operation, 8 rats at each time point. Before the experiment, rats in each group were fasting for 12 hours, free drinking water. SAP group: 5%. Sodium taurocholate 0.1 ml / 100 g retrograde cholangiopancreatic injection, Group A of induced SAP model: after operation, the rats were injected with 0.1 ml / 100g body weight of normal saline) retrograde cholangiopancreatopancreatic injection. After the operation, 0.9% sodium chloride solution was subcutaneously injected into the root of the thigh of rats to supplement the lost fluid, and the rats still fasted. 24 rats in each group were divided into 6 hours and 12 hours for 24 hours, 8 rats were examined at each time point. Gross changes of pancreas and intestine were observed with naked eyes. Blood samples were collected from abdominal aorta at 5 ml, and serum samples were collected after centrifugation. The serum samples were stored at -20 鈩，

本文編號(hào)：1668986