【作者】 陈德招；

【导师】 黄鹤光；

【作者基本信息】 福建医科大学 ， 外科学， 2010， 硕士

【摘要】 目的探讨羟乙基淀粉对SAP大鼠脑毛细血管渗漏的影响。方法将雄性SD大鼠50只按完全随机法分为假手术(sham operation, SO)组、重症急性胰腺炎(severe acute pancreatitis,SAP)组、羟乙基淀粉(hydroxyethyl starch,HES)治疗组,每组又分为6h、24h两个亚组,其中24hSAP组10只,余亚组各8只。以胰胆管逆行注射5%牛磺胆酸钠建立SAP模型。观察6h、24h后各组测血清TNF-α以及胰腺、脑组织病理,干湿重法检测脑含水率,RT-PCR检测脑组织AQP4mRNA表达,免疫组化检测脑组织AQP4蛋白表达。结果SO组、SAP组、HES治疗组6h血清TNF-α分别为(35.84±11.91)pg/ml、(97.14±6.70)pg/ml、(78.29±4.77)pg/ml,24h血清TNF-α分别为(38.58±12.22)pg/ml、(148.49±24.77)pg/ml、(112.50±7.11)pg/ml,组间差异均显著(P<0.05);6h脑组织含水率分别为(76.98±0.57)%、(79.72±0.62)%、(78.13±0.25)%,24 h脑组织含水率分别为(77.30±0.83)%、(80.44±0.54)%、(78.59±0.42)%,组间差异均显著(P<0.05);6h脑组织AQP4mRNA表达分别为0.5083±0.0466、0.7735±0.0243、0.6767±0.0255,24 h脑组织AQP4mRNA表达分别为0.5480±0.0488、0.8142±0.0168、0.7181±0.0188,组间差异均显著(P<0.05);6h脑组织AQP4蛋白表达分别为3.25±1.04、6.88±1.89、4.63±2.07,24 h脑组织AQP4蛋白表达分别为3.50±0.93、7.50±1.60、5.63±1.69,组间差异均显著(P<0.05)。SAP6h、24h两亚组血清TNF-α、脑组织含水率、脑组织AQP4mRNA、脑组织AQP4蛋白表达均较SO组显著增高(P<0.05),HES治疗组6h、24h两亚组血清TNF-α、脑组织含水率、脑组织AQP4mRNA、脑组织AQP4蛋白表达均较SAP组显著降低。结论羟乙基淀粉(130/0.4)可能通过抑制炎症因子TNF-α水平,间接下调脑组织AQP4表达,致脑毛细血管渗漏作用减弱。羟乙基淀粉(130/0.4)对改善SAP脑毛细血管渗漏有一定的意义。更多还原

【Abstract】 Objective To investigate the effect of hydroxyethyl starch on brain capillary permeability in rats with severe acute pancreatitis.Methods 50 male Sprague-Dawley rats were randomly divided into sham operation(SO) group, severe acute pancreatitis(SAP)group, hydroxyethyl starch(HES) treated group.Each group was divided into two subgroups as 6h and 24h,with 8 rats each subgroup except for 10 rates in 24h SAP group.Model was induced by injecting 5% sodium taurocholate into pancreaticobiliary.Serum TNF-α,the brain water content,pathological changes of brain and pancreas were measured and the expression of AQP4 was determined by RT-PCR plus immunohistochemistry 6h and 24h after induction.Result The levels of serum TNF-αin sham operation(SO) group,SAP group, hydroxyethyl starch(HES) treated group were (35.84±11.91)pg/ml、(97.14±6.70)pg/ml、(78.29±4.77)pg/ml in 6h,they were (38.58±12.22)pg/ml、(148.49±24.77 ) pg/ml、( 112.50±7.11 ) pg/ml in 24h,with significant difference(P<0.05). The water content were (76.98±0.57)%、(79.72±0.62)%、(78.13±0.25)% in 6h,they were (77.30±0.83)%、(80.44±0.54)%、(78.59±0.42)% in 24h, with significant difference(P<0.05). The expression of AQP4 mRNA were 0.5083±0.0466、0.7735±0.0243、0.6767±0.0255 in 6h,they were 0.5480±0.0488、0.8142±0.0168、0.7181±0.0188 in 24h, with significant difference(P<0.05). The expression of AQP4 proteins were 3.25±1.04、6.88±1.89、4.63±2.07 in 6h,they were 3.50±0.93、7.50±1.60、5.63±1.69 in 24h,with significant difference(P<0.05).Both in 6h and 24h,compared with sham operation group,the levels of serum TNF-α,the water content and the expression of AQP4 mRNA and proteins in SAP group were significantly increased(P<0.05).Compared with SAP group,the levels of serum TNF-α,the water content and the expression of AQP4 mRNA and proteins decreased obviously in HES treated group(P<0.05).Conclusions HES may inhibit the inflammatory factor--TNF-α,indirectly down-regulate the expression of AQP4,which may play an important role to decrease the effect of brain capillary permeability in SAP.HES may alleviate the brain capillary permeability in SAP.更多还原