重症急性胰腺炎时胰腺组织细胞凋亡与病变严重程度的关系

目的探讨实验性重症急性胰腺炎（SAP）胰腺组织细胞凋亡与胰腺病变严重程度的关系。方法28只SD大鼠随机分为两组：对照组7只、SAP组21只。牛磺胆酸钠诱导SD大鼠SAP模型，于造模成功后3、6、12h分别处死7只。检测血清淀粉酶浓度、胰腺组织学损伤评分（HI），TUNEL法检测胰腺组织细胞凋亡指数（AI）、免疫组化法检测Fas／FasL表达。结果12h时SAP组大鼠死亡1只，对照组无死亡。SAP组的血清淀粉酶浓度（U／L）在3h．6h、12h时分别为3904±737、6133±882、10606±2641（对照组1518±562，P=0．000），相应时点的H1分别是4．85±1．35、8．14±1．34、11．00±1．26（对照组为1．57±0．79，P=0．000），各组间差异有显著统计学意义。对应时间点的胰腺AI分别是1．200±0．497、0．886±0．389和0．700±0．352（对照组为1．028±0．403，），12h与3h的差异有统计学意义（P=0．047）。Fas的表达强度分别为108．00±10．02、93．14±8．17、73．33±9．52（对照组为102．00±13．24，P＝0．001），FasL分别为83．86±31．13、79．57±9．78、73．33±15．79（对照组为88．57±7．68，P=0．023）。SAP组AI与HI（r=-0．510，P=0．022）、AI与AMY（r=-0．471，P：0．036）分别呈负相关关系，Fas与AI（r=0．572，P=0．008）呈正相关关系。结论在实验性SAP大鼠中，胰腺组织细胞凋亡指数与胰腺组织学损伤程度呈负相关，诱导凋亡可能减轻胰腺炎的进展有关。

A study on the relationship between pancreatic cell apoptosis and pancreatic lesions in rat with acute severe pancreatitis

Objective To investigate the relationship between pancreatic cell apoptosis and pancreatic lesions of experimental acute severe pancreatitis （SAP）. Methods 28 SD rats were randomly divided into two groups, control （7 rats） and SAP group （21）. In SAP group, severe pancreatitis was induced by sodium tanrocholate and then every 7 rats were killed respectively at the 3,6,12 hour after the operation. The serum amylase level and pancreatic histological index （HI） were calculated. The apoptotic index （AI） and expression of Fas/FasL in the pancreas were detected by TUNEL and immunohistocbemical method respectively. Results At the 12h,one rat died in SPA group and non in the control. The.concentration of serum amylase（U/L） were 3904 ± 737,6133 ± 882,10606± 2641 respectively at the 3h,6h and 12h point（ 1518 ± 562 in the control,P =0. 000）. And the His were 4. 85 ± 1.35,8.14 ±1.34,11.00 ± 1.26 at the same time points ,and there was a significant difference among them （ 1.57 ± 0. 79 in the control,P = 0. 000）. The AI decreased in a time - dependent manner（3 h：1. 200 ±0. 497、6 h：0. 886 ± 0. 389、12 h：0. 700 ±0. 352 and 1. 028 ±0. 403 in the control,P 〈0. 05） ,and the expressions of Fas/FasL showed a similar manner in SPA group. Either between AI and HI （ r = - 0. 510, P = 0. 022 ） , or between AI and AMY （ r = - 0. 471, P = 0. 036）negative correlations were detected in SAP group, and a positive relationship was shown between AI and Fas（ r = 0. 572 ,P = 0. 008）. Conclusion The data indicated that there was a negative relationship between apoptosis and the severity of pancreatic lesions in SAP,and induction of pancreatic cell apoptosis may slow down the progress of a severe pancreatitis.