重症急性胰腺炎外周血中性粒细胞凋亡及其调控机制的研究

目的初步探讨重症急性胰腺炎（SAP）外周血中性粒细胞的凋亡及凋亡抑制蛋白survivin在SAP中性粒细胞凋亡延迟调控中的作用。方法48只SD大鼠随机分为急性坏死性胰腺炎（ANP）组和假手术（SO）组。采用胰胆管逆行注射4％牛磺胆酸钠（1ml／kg体重）制模，制模后24、48、72h分别处死动物。取胰腺组织评估病理变化；TUNEL荧光标记法检测外周血中性粒细胞的凋亡；RTPCR检测外周血中性粒细胞survivin mRNA的表达。结果ANP组胰腺病理评分较（SO）组明显升高（P〈0．05）。ANP组中性粒细胞凋亡率较SO组明显降低，随时间延长更明显（P〈0．05）。ANP组中性粒细胞survivin mRNA水平均较SO组明显升高，且随时间延长更明显（P〈0．05）。ANP组中性粒细胞凋亡率分别与胰腺病理评分和survivin mRNA水平呈负相关（r=0．97，r=0．99，P〈0．05）。结论ANP时外周血中性粒细胞凋亡明显延迟，survivin mRNA高表达．表明survivin在调控SAP外周血中性粒细胞凋亡延迟机制中可能具有重要作用。

Peripheral neutrophil apoptosis in patients with severe acute pancreatitis and its regulating mechanisms

Objective To study the apoptosis of peripheral blood neutrophil (PBN) and the regulatory role of survivin (apoptosis inhibitory protein) in delaying PBN apoptosis in rats with severe acute pancreatitis (SAP). Methods Forty-eight SD rats were randomly divided into SAP group and sham operation (SO) group. SAP model was induced by retrograde injection of 4% sodium taurocholate(1 ml/kg) into the bili-pancreatic duct in rats. Rats were killed at 24, 48, and 72 h after injection and the pancreatic tissues were harvested for assessing the histopathological changes. The neutrophil apoptosis was measured by TUNEL staining and the expression of survivin mRNA in PBN was determined by RT-PCR. Results The pancreatic histopathologic scores in SAP group were obviously higher than those in SO group(P < 0.05). Neutrophil apoptosis rates in SAP group were obviously decreased compared with those in SO group, and the decrease became more obvious as time went on( P < 0.05). Survivin mRNA level in PBN in SAP group increased significantly compared with that in SO group, and the increase become more obvious as time went on (P < 0.05). In SAP group, apoptosis of neutrophil were negatively correlated with both the pancreatic histopathologic scores (r = 0.97, P < 0.05) and survivin mRNA expression(r = 0.99, P < 0.05). Conclusions During SAP, apoptosis of PBN is obviously delayed and of survivin mRNA is highly expressed in the neutrophils, indicating that survivin may play an important role in peripheral neutrophil apoptosis during SAP.