重症胰腺炎早期Th1/Th2型细胞因子变化的实验研究

目的研究辅助性T淋巴细胞Th1、Th2型细胞因子及Th1/Th2比值在重症胰腺炎(SAP)早期的变化,探讨Th1/Th2比值与SAP严重程度的关系。方法将56只Wistar大鼠体质量(250±30)g]随机分为假手术组(A组,n=28)和SAP组(B组,n=28),A组和B组又分为2、6、12、24h组,每组7只。B组行逆行胰胆管匀速注射5%牛磺胆酸钠;A组开腹后仅翻动胃十二指肠数次。然后按规定时间(2、6、12、24h)处死大鼠,观察腹水量和胰腺病理严重程度,检测腹水淀粉酶、血清淀粉酶和Th1、Th2型细胞因子及Th1/Th2比值的变化。结果 (1)A组胰腺无炎症反应,Th1、Th2型细胞因子及Th1/Th2比值无明显变化(P>0.05);(2)B组随着SAP病情的加重Th1型细胞因子逐步降低,Th2型细胞因子逐步升高,Th1/Th2比值降低(P<0.05)。结论 SAP早期Th1/Th2比值呈失衡状态,趋向Th1抑制和Th2极化,其失衡程度与SAP严重程度有关。

Experimental study on changes of Th1/Th2 cytokines in early severe acute pancreatitis

Objective To explore the changes of Th1/Th2 cytokines and their ratio as well as the relation between the ratio of Th1/Th2 and the severity in early severe acute pancreatitis （SAP）. Methods 56 Wistar rats wcight（250±30）g] were randomly divided into sham operation group （group A,n=28） and SAP group （group B, n=28）. Each group was divided into 2 h,6 h,12 h and 24 h subgroups again,7 cases per group. Group B was induced by evenly retrograde injection of 5% sodium tanrocholate to pancreatic duct; the stomach and duodenum were only flipped several times after opening the abdomen in group B;then the rats were put to death at set time. The quantity of ascites and pathologic severity of pancreatic tissue were observed and ascites amylase, serum amylase and the change of Th1/Th2 cytokines and their ratio were detected. Results （1）There were no inflammatory reaction in pancreatic tissue and no change of Th1/Th2 cytokines as well as their ratio in group A; （2）With the aggravation of SAP, Th1 cytokine stepped down,Th2 cytokine stepped up and the ratio of Th1/Th2 falled in group B（P〈0.05）. Conclusion The imbalance of Th1/Th2 inclines to Thl suppression and Th2 polarization in early SAP,and the imbalance extent is related to the severity of SAP.