【摘要】 目的　探讨急性坏死性胰腺炎 (ANP)肠粘膜屏障形态和功能的变化及生长激素 (GH)的作用。方法　采用胰胆管内逆行注射 5 %牛磺胆酸钠溶液诱导大鼠ANP。实验分 3组 :假手术组、ANP+生理盐水 (NS)组、及ANP +GH组。术后 2 4h取末端回肠 ,观察病理形态变化 ;应用12 5I 白蛋白测定肠壁通透性 ;RT PCR检测胰岛素样生长因子 (IGF 1)mRNA表达。结果　ANP大鼠肠粘膜间质充血水肿 ,炎症细胞浸润 ,上皮细胞脱落 ;粘膜厚度 ,绒毛高度及隐窝深度减少 ;微绒毛稀疏、脱落 ;肠壁通透性增加 ;肠IGF 1mRNA表达下调。GH可减轻肠粘膜病理损伤 ,降低通透性 ,上调IGF 1mRNA表达。结论　ANP肠粘膜屏障形态和功能受损 ,GH通过上调肠粘膜IGF 1mRNA表达减轻肠粘膜形态和功能受损。更多还原

【Abstract】 Objective To study the gut barrier dysfunction in acute necrotizing pancreatitis (ANP) and the effect of growth hormone(GH).Methods All rats were assigned to three groups randomly: sham operation (SO), ANP+normal saline(NS), and ANP+GH. ANP model was induced by retrograde injection of 5% sodium taurocholate into biliary pancreatic duct. Pathological studies for ileal mucosa were evaluated with the method of morphological measurement, transmission and scanning electronmicroscopy. Intestinal permeability was measured by means of albumin clearance of 125 I labeled human serum albumin. Expression of insulin like growth factor 1 (IGF 1) mRNA in ileum and liver were determined by RT PCR.Results In rats with ANP, there were vascular congestion, interstitial edema and infiltration of inflammatory cells and exfoliation of epithelial cells in the ileal mucosa. Morphological measurement indicated that ileal mucosa was atrophic. The intestinal epithelial microvilli were rare, exfoliative, and deranged. The intestinal permeability in ANP rats was increased significantly. GH could obviously improve the pathological changes and permeability of ileum. Expression of IGF 1 mRNA in ileum was markedly decreased after induction of ANP, but could be up regulated by GH administration.Conclusions There was intestinal barrier dysfunction during the course of ANP in rats. GH played a role in the maintenance of integrity of intestine. The underlying mechanism may be related to the enhancement of IGF 1 mRNA expression in ileum.更多还原