【摘要】 目的　探讨肺泡巨噬细胞活化在急性坏死性胰腺炎 (ANP)肺损伤中的作用。　方法30只成年SD大鼠随机分为正常对照组、ANP后 1、3、6、12h组 ,每组 6只。逆行性胰胆管注射 3%牛磺酸钠建立ANP大鼠模型 ,正常对照组大鼠自胆胰管内逆行注入生理盐水。经支气管肺泡灌洗获取肺泡巨噬细胞 ,检测支气管肺泡灌洗液中蛋白含量、肺组织髓过氧化物酶 (MPO)水平、肺泡巨噬细胞分泌肿瘤坏死因子α(TNFα)及一氧化氮 (NO)水平。以反转录聚合酶链反应 (RT PCR)法测定肺泡巨噬细胞TNFαmRNA、诱导型一氧化氮合酶 (iNOS)mRNA表达情况。行肺、胰腺组织病理学检查并评分。结果　ANP大鼠肺损伤随着病情进展而逐渐加重 ;肺组织MPO及支气管肺泡灌洗液中蛋白含量逐渐升高 ,12h达最高值 ,分别为 (10 78± 0 5 8)U/g和 (2 0 11 0± 10 5 5 ) μg/ml;肺泡巨噬细胞分泌TNFα、NO水平逐渐升高 ,至 6h达到高峰 ,分别为 (16 2 4 2± 149 2 )pg/ml和 (88 8± 6 5 ) μmol/L ,12h又回落。ANP发生后 ,肺泡巨噬细胞TNFαmRNA、iNOSmRNA的表达情况与TNFα、NO的变化趋势相似。ANP大鼠各组指标与正常对照组相比差异均有显著性意义 (P <0 0 5 )。组织学评分结果表明 ,随着胰腺损伤的加重肺损伤也逐渐加重。肺泡巨噬细胞TNFαmRNA、iNOSmRNA?更多还原

【Abstract】 Objective To discuss the role of alveolar macrophage activation in rats with acute necrotizing pancreatitis(ANP) associated with lung injury. Methods 30 adult Sprague-Dawley rats were randomly divided into five groups(n=6): normal control group, one-hour group, three-hour group, six-hour group and twelve-hour group after ANP induction. ANP was induced by intraductal administration of 3% sodium taurocholate, while the normal control received an infusion of physiological saline. Alveolar macrophages were harvested by bronchoalveolar lavage. The protein content of lavage fluids, the myeloperoxidase of lung tissue(MPO), and tumor necrosis factor α(TNFα) and nitric oxide(NO)secreted by alveolar macrophages were examined. The expression of TNFα mRNA and inducible nitric oxide synthase (iNOS) mRNA was measured with reverse transcription-polymerase chain reaction technique. Histology of the lung and pancreas was scored in a blinded fashion. Results Lung injury was gradually aggravated with disease progression. The level of myeloperoxidase of lung tissue and protein content of bronchoalveolar lavage fluids increased progressively and reached the peak at 12 hour [(10.78±0.58) U/g for MPO and (2 011.0±105.5) μg/ml for protein respectively]. TNFα and NO secreted by alveolar macrophages were gradually elevated and peaked on the sixth hour, the maximums were (1 624.2±149.2) pg/ml and (88.8±6.5) μmol/L respectively,but decreased on the twelfth hour. The expression of TNFα mRNA and iNOS mRNA was similar with the changes of TNFα and NO,upregulated after induction of acute necrotizing pancreatitis and reached their peaks on the sixth hour, then downregulated on the twelfth hour. All the parameters of ANP groups compared to control group were statistical significant (P<0.05). The histology scores demonstrated an increasing damage of the lung. The expression of TNFα mRNA and iNOS mRNA is closely related to lung injury (r=0.67 for TNFα mRNA and r=0.64 for iNOS mRNA respectively, P<0.01). Conclusion The activation of alveolar macrophage may play an important role in lung injury associated with acute necrotizing pancreatitis.更多还原