胆总管梗阻解除前后脑肠肽及免疫水平变化的实验研究

目的:探讨胆总管梗阻解除前后脑肠肽水平的变化及其免疫调节作用.方法:将100只Wistar大鼠随机分为假胆总管梗阻组(A组)、胆总管梗阻组(B组)、假解除胆总管梗阻加生理盐水治疗组(C组)、解除胆总管梗阻加生理盐水治疗组(D组)、解除胆总管梗阻加善宁治疗组(E组),应用放射免疫分析法和流式细胞分析技术动态观察各组术后第1、7天血中血管活性肠肽(VIP)、P物质(SP)、白细胞介素-2(IL-2)和CD 4、CD8 水平.结果:血浆VIP、SP水平B组较A组明显升高(P＜0.05),D组较C组、E组较D组明显降低(P＜0.05).IL-2水平B组较A组降低,D组较C组、E组较D组升高(P＜0.05).术后第7天B组较A组、D组较C组CD4 降低、CD8 升高(P＜0.05).E组较D组CD4 升高、CD8 降低(P＜0.05).结论:梗阻性黄疸大鼠胆总管梗阻解除前后,血中VIP、SP等脑肠肽(BGP)呈高表达,伴有机体细胞免疫功能抑制;解除胆总管梗阻,应用善宁治疗可以通过调控脑肠肽有效地改善机体的免疫功能.

The changes of brain-gut peptides and immunologic function in the rats before and after relief of biliary obstruction

Objective:To investigate the changes and the adjusting effects of brain-gut peptides (BGP) on immunologic function in the rats before and after relief of biliary obstruction.Methods:One hundred Wistar rats were randomly divided into five groups,including sham common bile duct ligation group (group A),common bile duct ligation group (group B),sham relief of biliary obstruction normal saline group (group C) ,relief of biliary obstruction normal saline group (group D) and relief of biliary obstruction Sandostatin (group E).At 1d,7d after the operation of each group,the changes of plasma vasoactive intestional peptide (VIP),substance P(SP),serum interleukin-2(IL-2) and serum T-lymphocytic subsets (CD4 ,CD8 )were determinded by radioimmunoassay and flowcytometry .Results:Plasma VIP and SP were increased in group B compared with group A(P<0.05),declined in group C compared with group B,and declined in group E commpared with group D(P<0.05).Serum IL-2 was decreased in group B compared with A,and elevated in group D compared with C ,and elevated in group E compared with D (P<0.05).CD4 declined and CD8 ascended both in group B and in group D compared with group A and group C respectively at the 7th day after the operation (P<0.05),and CD4 was higher and CD8 was lower in group E than in group D(P<0.05).Conclusion:Plasma BGPs (VIP,SP) are increased in rats before and after relief of biliary obstruction,with the cellular immunity depressed.Relieving the bile duct obstruction and treating with Sandostatin can improve the immune function by adjusting the levels of BGP.