【摘要】 目的探讨脾脏在大鼠急性胰腺炎中对肠屏障功能的影响。方法大鼠胰胆管内注入3%牛磺胆酸钠(0.7ml/kg)及胰蛋白酶(3000u/kg)制成急性胰腺炎模型。实验大鼠随机分成4组假手术组,脾切除组,脾切除+急性胰腺炎组,急性胰腺炎组。分别观察各组血清TNFα,IL1β,IL6及IL10水平,测细菌移位率,取末段回肠行光镜及透射电镜检查观察肠黏膜受损情况。结果脾切除+急性胰腺炎组TNFα,IL1β,IL6及IL10的测得值分别为3.06±3.61,16.46±5.52,19.90±6.89,6.94±3.93,急性胰腺炎组的测得值分别为19.93±2.38,42.79±4.31,20.19±3.35,39.28±12.69,其中TNFα,IL1β及IL10的值脾切除+急性胰腺炎组与急性胰腺炎组相比差异有显著意义(P<0.05);脾切除+急性胰腺炎组细菌移位率为40%,急性胰腺炎组细菌移位率为93.3%,二者差异有显著意义(P<0.05)。从病理学检查结果看,脾切除+急性胰腺炎组肠黏膜上皮仅轻微水肿,肠黏膜屏障基本完整,而急性胰腺炎组肠黏膜上皮水肿明显,绒毛坏死,上皮细胞变性,炎性细胞浸润及细菌移位。结论脾脏在急性炎症反应中,可以明显促进炎性介质的产生和释放,加重炎症反应。脾脏切除后可减少促炎因子的产生和释放,肠黏膜屏障受损减轻,细菌移位率下降。更多还原

【Abstract】 Objective:To investigate the effect of spleen on the function of intestinal barrier in acute pancreatitis.Methods:Models of acute necrotizing pancreatitis (ANP) were induced in SD rats by injection of 3% sodium taurocholate and trypsin into biliopancreatic duct. All rats were divided into four groups randomly: sham operation group, splenectomy group, splenectomy and acute pancreatitis group and actue pancreatitis group. The serum levels of TNF-α, IL-1β, IL-6 and IL-10 and the rate of bacterial translocation (BT) in each group were examined. The terminal ileum was excised to observe the injury of intestinal mucosal barrier under light microscope and electron microscope.Results:The serum levels of TNF-α, IL-1β, IL-6 and IL-10 in splenectomy and acute pancreatitis group were 3.06±3.61, 16.46±5.52, 19.90±6.89 and 6.94±3.93, and in acute pancreatitis group were 19.93±2.38, 42.79±4.31, 20.19±3.35 and 39.28±12.69, respectively. The values of TNF-α, IL-1β and IL-10 were significantly lower in splenectomy and acute pancreatitis group than that in acute pancreatitis group (P<0.05). The rate of bacterial translocation was 40 percent in splenectomy and acute pancreatitis group, 93.3% in acute pancreatitis group,the former was statistically different from the latter (P<0.05). Histologic examination revealed mild edema of mucosal epithelium and fundamentally intact mucosal barrier in splenectomy and acute pancreatitis group, whereas acute pancreatitis group revealed severe injuries, including apparent edema, necrosis of the intestinal villi, degeneration of epithelial cell, infiltration of neutrophils and bacterial translocation.Conclusion:Spleen may play an important role on promoting the production and release of inflammatory mediators in acute inflammatory response. The role can aggravate the inflammatory response. Splenectomy can reduce the production and release of inflammatory mediators, thus decrease the damage of intestinal mucosal barrier and the rate of BT.更多还原