【摘要】 目的探讨白蛋白对重症急性胰腺炎(SAP)SD大鼠远隔脏器的保护作用及可能机制。方法 105只SD大鼠随机分为4组:假手术组、模型组、常规治疗组及白蛋白组。常规治疗组:于建立SAP模型成功30 min后,通过大鼠阴茎背静脉注入乌司他丁1万U/kg,经皮下给药注入奥曲肽25μg/kg;白蛋白组:于建立SAP模型成功30 min后,在常规治疗组用药的基础上,通过大鼠阴茎背静脉注入5%的人血白蛋白10 ml/kg;假手术组及模型组:于同时间,在同部位,以同方式注入等量生理盐水。于治疗后3 h、6 h、12 h,采用全自动生化分析仪检测四组血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、尿素氮(BUN)、肌酐(Cre)值,运用流式细胞仪检测外周血中脱落的血管内皮细胞(VEC),应用病理学评分对肝、肺、肾脏组织进行病理学评估。结果与假手术组相比,模型组、常规治疗组、白蛋白组各时间点血清ALT、AST、BUN、Cre、VEC均明显升高,治疗后3 h、6 h、12 h,白蛋白组血清ALT、AST、BUN、Cre、VEC均低于常规治疗组,两组比较差异均具有统计学意义(均P<0.05)。与假手术组相比,模型组、常规治疗组、白蛋白组大鼠肝、肺、肾组织病理学评分显著升高,经治疗12 h后白蛋白组肝、肺、肾组织病理学评分均明显低于常规治疗组,两组比较差异有统计学意义(P<0.05)。结论白蛋白能够通过中和SAP时已经入血的胰蛋白酶,降低胰酶对血管内皮细胞的损伤,进而发挥对远隔脏器的保护作用。更多还原

【Abstract】 Objective To investigate the protective effect and the possible mechanism of albumin to the distant organs in the rats model with severe acute pancreatitis. Methods 105 SD rats were randomly divided into 4 groups: sham operation group,model group,routine treatment group and albumin group. In the conventional treatment group,30 minutes after the successful establishment of the SAP model,Ulinastatin was infused into the dorsal penile vein of rats at 10,000 U / kg and injected subcutaneously with octreotide 25 μg / kg; albumin group: after 30 min,5%human serum albumin( 10%) was injected into the dorsal vein of the penis in the normal control group. The sham operation group and the model group were given the same way,Into the same amount of saline. At 3 h,6 h and 12 h after therapy,the serum ALT,AST,BUN,Cre value were detected by automatic biochemical analyzer,the peripheral shedding vascular endothelial cell counts were identified by flow cytometer; at 12 h after therapy,the pathological morphological changes of liver,lung,kidney tissue were evaluated by pathological score within sham control,model group,conventional treatment group and albumin group. Results Compared with those in sham- operated group,ALT,AST,BUN,Cre,VEC were significantly increased in model group,routine treatment group and albumin group at 3 h,6 h and 12 h after treatment,serum albumin ALT,AST,BUN,Cre,VEC were lower than those of the conventional treatment group,the difference was statistically significant( P < 0. 05). Compared with the sham group,the pathological scores of the liver,lung and kidney were significantly increased in the model group,the conventional treatment group and the albumin group. After 12 hours of treatment,the histopathological scores of albumin liver,lung and kidney were Significantly lower than the conventional treatment group,the difference between the two groups was statistically significant( P < 0. 05). Conclusion Albumin can reduce vascular endothelial cells damage by degrading trypsin which have released into the circulation in SAP,by neutralizing albumin and then play a protective effect on remote organs.更多还原