急性胰腺炎胰腺内皮素mRNA表达与肠壁通透性的关系及丹参的影响

目的探讨重症急性胰腺炎（SAP）胰腺内皮素（ET-1）mRNA表达与肠壁通透性的关系及丹参的作用。方法Wistar大鼠45只，随机分为3组：SAP模型组（SAP组），SAP丹参治疗组（T纽）和假手术组（C组），每组15只。SAP组用5％的牛磺胆酸钠复制大鼠SAP模型，T组按SAP组方式复制SAP模型，并分别即刻、8h及18h予丹参注射液肌注，剂量2mL／kg。24h处死动物。用原位杂交检查胰腺组织ET-1mRNA表达，检测血中ET-1、淀粉酶（AML）和内毒素（LPS）以及胰腺和回肠的病理变化；^125I-白蛋白测定肠壁通透性。结果SAP组胰腺和回肠病理损害明显，胰腺ET-1mRNA呈强阳性表达，血中ET-1、AML、LPS含量及腹水量以及肠壁通透性均显著高于C组（P〈O．01）；与SAP组比较，T组胰腺及回肠病理损害明显减轻，胰腺ET-1mRNA表达强度较弱，血中ET-1、AML、LPS及腹水量均显著下降（P〈O．01），^125I-白蛋白测定肠壁通透性降低。结论（1）SAP时肠壁通透性增加的原因之一是胰腺ET-1mRNA的过度表达，使血中ET-1浓度升高，造成肠壁通透性增加；（2）丹参可减轻胰腺和肠道损伤，其机制之一是下调胰腺内ET-1mRNA的表达，对SAP及其肠道损伤有一定治疗作用。

White blood cell count acute coronary syndrome pathogenetic condition

Objective To investigate the relationship between endothelin-1 （ET-1） mRNA expressions of pancreatic tissues and intestinal permeability and the effect of salvia miltiorrhiza on the change in rats with severe acute pancreatitis（SAP）. Methods Forty-five Wistar rats were randomly divided into threegroups. Models groups of SAP （group SAP, n= 15）were induced by retrograde injection of 5% sodium taurocholate （0. 15 mL/100 g） to common biliary-pancreatic duct; Therapeutic group （group T, n= 15） were made as same as group SAP besides salvia miltiorrhiza （2 mL/kg） were injected into muscular on the instant, 8 h, 18 h after operation; Sham operation group （group C, n= 15） only moved pancreas several times at site. After 24 hours. The ET-1 mRNA expressions of pancreas was determined by in situ hybridization. Serous amylase （AML）. Endothelin-1 （ET-1）. Lipopolysac- charide （LPS） and ascites were examined. Histopathology of pancreas and ileal were observed. Inntestinal permeability was measured by albumin clearance of 125 I-labeled rat serum albumin. Results There is ET-1 mRNA overexpressions of pancreas for group SAP compared with group T （P〈0. 01）. The serous ET-1, AML, LPS and ascites and intestinal permeability in group SAP are much higher than group C （P〈0. 01） and group T （P〈0. 01）. There are extensivebleeding, necrosis, marked in- flammatory cell infiltration and marked oedema of the pancreas, and intestinal mucosa oedema and in- filtration of inflammatory ceils and intestinal epithelial villi partly drop in group SAP while these pathological changes of pancreas and gut in group T are not severe as group SAP. However pathology of pancreas is normal in group C. Conclusion There is severe intestinal damage related with ET-1 mRNA overexpressions of pancreas. Salvia miltiorrhiza can make down-regulated the ET-1 mRNA expressions of pancreas and improve intestinal damage in SAP.