乌司他丁对重症急性胰腺炎大鼠肾脏细胞凋亡及bcl-2基因表达的影响

目的探讨乌司他丁(UTI)对重症急性胰腺炎(SAP)大鼠肾脏细胞凋亡及bcl-2基因表达的影响。方法60只大鼠随机均分为假手术组、SAP组和UTI组,大鼠SAP模型采用5%牛磺胆酸钠逆行胆胰管注射法建立。于建模后6h及14h时测定血Cr及BUN,于光镜及电镜下观察肾组织病理变化,TUNEL法检测肾脏细胞凋亡情况,SABC免疫组化染色法测定肾脏组织bcl-2基因的蛋白表达。结果SAP组光、电镜下见肾脏组织损害明显,血Cr、BUN、肾脏细胞凋亡指数和bcl-2表达均高于假手术组(P<0.05,P<0.01),且除bcl-2表达外,均随病程延长逐渐升高(P<0.05);经UTI治疗后,光、电镜下见肾脏组织损害减轻,血Cr、BUN和肾脏细胞凋亡指数较SAP组明显下降(P<0.05),而bcl-2表达增强(P<0.05)。肾脏细胞凋亡指数与血BUN和Cr均呈正相关(r=0.807,P<0.05;r=0.812,P<0.05)。结论UTI对肾功能的保护作用可能部分是通过调节凋亡相关基因bcl-2的表达从而影响细胞凋亡实现的。

Effects of Ulinastatin on Renal Apoptosis and Expression of bcl-2 in Rats with Severe Acute Pancreatitis

Objective To explore the effects of ulinastatin(UTI) on renal apoptosis and expression of bcl-2 in rats with severe acute pancreatitis(SAP).Methods Sixty rats weighing 250-300 g were randomized divided into 3 groups:pseudo-operation group(SO group,n=20),SAP group(n=20) and UTI treated group(UTI group,n=20).The model of SAP was established by retrograde injection of 5% sodium taurocholate solution into the biliopancreatic duct in the rats.Serum Cr and BUN were determined.The left kidneys were resected for light and electronic microscopic study.Renal cell apoptosis was determined by TUNEL.Expression of bcl-2 was detected by immunohistochemical staining of SABC.Results Serum Cr,BUN,renal cell apoptotic index and bcl-2 expression were markedly increased in SAP group compared with SO group(P<0.05,P<0.01),Renal tissue injuries were aggravated in SAP group under light and electronic microscopic study as well.In UTI group,serum Cr,BUN and renal cell apoptotic index were decreased significantly while the expression of bcl-2 increased remarkably and renal tissue injuries relieved compared with SAP group(P<0.05).Positive correlations were found between the renal cell apoptotic index and BUN as well as Cr(r=0.807,P<0.05;r=0.812,P<0.05).Conclusion The protective effect of UTI on SAP renal injury is probably through increasing bcl-2 expression and decreasing apoptosis.