腹腔置管引流对SAP大鼠肾损伤影响的实验研究

目的 研究腹腔置管引流对重症急性胰腺炎（SAP）大鼠肾损伤的影响及作用机制.方法 将72只大鼠随机分为3组：SAP组（A组）、SAP引流组（B组）、假手术组（C组）.每组24只,各组分6、12、24 h三个时间点,每时间点分配8只.A组采用开腹后逆行胰胆管注射牛黄胆酸钠造成SAP模型,B组在A组基础上行腹腔置管引流,C组仅行开腹手术.各组分别于处理后6、12、24 h取大鼠血、腹水、胰腺及肾组织,测定血、腹水中淀粉酶和NF-κB水平;胰腺及肾组织HE染色观察病理变化;免疫组化法测肾组织NF-κB的表达水平.结果 A组和B组较C组大鼠血及腹水淀粉酶、NF-κB显著升高,胰腺及肾出现病理变化,肾组织NF-κB表达增多;B组较A组前述变化显著减轻.结论 腹腔置管引流可以减轻大鼠SAP肾损伤.

Experimental study on effects of intraperitoneal catheter drainage on renal injury of rats with severe acute pancreatitis

Objective To investigate the effects of intraperitoneal catheter drainage on the renal injury of rats with severe acute pancreatitis （SAP）and its mechanism. Methods Seventy two rats were randomly divided into SAP group （group A）, SAP drainage group （group B）, and the sham operation group （group C ）with 24 ones in each group. There were examinational time points, i. e. 6,12, and 24 h, and each time point was allocated with 8 rats. In group A, SAP model was ,established through retrograde cholangiopancreatography injection with sodium taurocholate. Group B received intraperitoneal catheter drainage based on the same treatment as group A. Group C received only the laparotomy. The rats＇blood, ascites, pancreatic gland, and nephridial tissue samples were obtained 6,12, and 24 h after the treatment in order to detect the level of amylase and NF-κB in blood and ascites. HE staining was carried out for pancreatic and nephridial tissues in order to observe the pathological changes. Immunohistochemical method was used to detect the expression level of NF-κB in nephridial tissues. Results Compared with the levels of group C,the levels of amylase and NF-κB in blood and ascites of group A and B increased significantly, and pathological changes occurred in pancreatic and renal tissues. The expression of NF-KB increased in renal tissues. The preoperative pathological changes in group B significantly decreased compared with those in group A. Conclusion Intraperitoneal catheter drainage can relieve the kidney injury in rats with severe acute panereatitis.