N-乙酰半胱氨酸对急性坏死性胰腺炎保护作用的实验研究

目的探讨N-乙酰半胱氨酸（NAC）对急性坏死性胰腺炎（ANP）的保护作用及作用机制。方法54只SD大鼠随机分为3组：假手术（SO）组、ANP组及NAC处理组。采用胰胆管逆行注射5%牛磺胆酸钠诱导大鼠ANP模型,NAC处理组于模型制作前30min腹腔内注射NAC（200mg/kg）进行预处理。分别观察各组大鼠血浆淀粉酶、TNF-α、IL-6、丙二醛（MDA）、肺组织髓过氧化物酶（MPO）、肺湿/干比值的变化,胰腺及肺组织病理改变,肺组织TNF-αmRNA的表达。结果ANP组血浆淀粉酶、TNF-α、IL-6、MDA、肺组织MPO、肺湿/干比值均较SO组明显升高（P〈0.05）,肺组织TNF-αmRNA表达较SO组显著增加（P〈0.01）,NAC处理组各检测指标均较ANP组显著降低（P〈0.05）,胰腺及肺组织病理损伤明显减轻。结论NAC可通过清除氧自由基、减少TNF-α、IL-6的产生等机制对ANP进行重要的治疗保护作用。

Experimental Study of the Protective Effect of N-Acetylcysteine on Acute Necrotic Pancreatitis

Objective To investigate protective effect and mechanism of N-Acetylcysteine（NAC）on acute necrotic pancreatitis（ANP）.Methods Fifty-four SD rats were randomized into three groups：the sham operation（SO）group,ANP group and NAC-pretreated group.The model of ANP was induced by retrograde injection of 5% sodium taurocholate into the bili-pancreatic duct in SD rats,NAC-pretreated group was given 200mg/kg NAC intraperitoneally 30 min before inducing ANP.The levels of amylase,TNF-α,IL-6,malondialdehyde（MDA）in plasm,and myeloperoxidase（MPO）in the lung,the wet /dry ratio of lung were measured.The histopathological changes of pancreatic and pulmonary tissue were evaluated and intrapulmonary TNF-αmRNA was detected.Results The levels of amylase,TNF-α,IL-6,MDA in plasm,the MPO in the lung and wet /dry ratio of lung were significantly increased in ANP group compared with those in the SO group（P0.05）,the expression of TNF-αmRNA in the lung was increased significantly in ANP group（P0.01）Compared with the ANP group,the indexes were significantly decreased in the NAC-pretreated group（P0.05）,the severity of pancreas and lung injury also significantly decreased in the NAC-pretreated group.Conclusion NAC may have protective effect on ANP by cleaning oxygen free radicals and decreasing the production of TNF-α and IL-6.