【摘要】 目的通过检测家兔急性胆囊炎模型血清肿瘤坏死因子-α(TNF-α)和C-反应蛋白(CRP)的浓度变化,以探讨生长抑素联合抗生素应用对急性胆囊炎的疗效及其可能的机理。方法建立家兔急性胆囊炎动物模型,45只家兔按随机数字表法均分为空白组、对照组及实验组3组。对照组家兔给予头孢唑啉钠及甲硝唑静脉注射,实验组家兔在对照组基础上加用生长抑素皮下注射,空白组家兔皮下注射等体积的生理盐水。给药3 d后,采用酶联免疫法测定血清中TNF-α及CRP浓度,并于光镜及透射电镜下观察各组家兔胆囊组织的病理学改变及超微结果改变。结果术后3 d实验组家兔血清TNF-α浓度为(401.6±48.7)pg/ml,明显低于空白组的(806.7±61.2)pg/ml和对照组的(767.3±67.4)pg/ml(P=0.000;P=0.000),而后2组之间的差异无统计学意义(P=0.196);实验组家兔血清CRP浓度为(16.2±1.1)mg/L,明显低于空白组的(72.8±8.9)mg/L和对照组的(55.4±1.2)mg/L(P=0.000;P=0.000),而空白组又明显高于对照组(P=0.018)。光镜观察结果:与空白组和对照组相比,实验组家兔胆囊纤维素及脓性渗出物明显减少,固有层水肿明显减轻,中性粒细胞浸润明显减少,炎症反应明显减轻;透射电镜观察结果:胆囊组织细胞间连接相对完整,线粒体和内质网水肿以及空泡变性明显减轻。结论生长抑素能降低家兔急性胆囊炎模型血清TNF-α和CRP浓度,减轻胆囊的炎症反应,并对胆囊黏膜细胞具有一定的保护作用。更多还原

【Abstract】 Objective To explore the therapeutic effect and its possible mechanisms of somatostatin combined with antibiotics on acute cholecystitis through the detection of serum tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP) in rabbits.Methods Forty-five rabbits were randomly averagely classified into three groups following the establishment of acute cholecystitis model: control group,blank group,and experimental group.The rabbits in control group received cefazolin sodium and metronidazoie by intravenous injection twice a day.The rabbits in experimental group got a hypodermic injection of somatostin(20 μg/kg) twice a day besides antibiotics,while these drugs were replaced by equal volume of normal saline for the rabbits in control group.The concentrations of serum TNF-α and CRP were detected by enzyme-linked immunosorbent assay and histomorphological and electron microscopic changes of gallbladder in rabbits were observed on 3 d after administer.Results The concentrations of serum TNF-α of rabbits in experimental group((401.6±48.7) pg/ml) were significantly lower than those in control group((767.3±67.4) pg/ml) and blank group((806.7±61.2) pg/ml),P=0.000 and P=0.000,while the difference between the latter two groups was not significant(P=0.196).The concentrations of serum CRP of rabbits in experimental group((16.2±1.1) mg/L) were significantly lower than those in control group((55.4±1.2) mg/L)and blank group((72.8±8.9) mg/L),P=0.000 and P=0.000,and which was higher in blank group compared with control group(P=0.018).The Histopathological results showed that gallbladder wall emerged mulifocality mucosal fluid necrosis,lamina propia hyperemia,bulk neutrophil infiltration and sequent alleviation of reaction in the rabbits of experimental group when compared with the rabbits of blank group and control group.Electron microscopic results demonstrated that the intercellular junction of gallbladder kept relative integrity and the swelling and vacuolar degeneration of mitochondria and endoplasmic reticulum obviously relieved.Conclusions Somatostatin can significantly reduce the concentrations of serum TNF-α and CRP in the model of rabbits acute cholecystitis,which may protect the mucous membrane of gallbladder from the inflammation reaction.更多还原