还原性谷胱甘肽对重症急性胰腺炎大鼠早期胰肝损伤的保护作用

目的阐明还原性谷胱甘肽对重症急性胰腺炎早期胰肝损害的保护作用。方法 54只雄性Wistar大鼠随机分三组,每组18只:A组为正常对照组,开腹后仅翻动胰腺,即关腹;B组为重症急性胰腺炎(SAP)组,以0.1 mL/min的速度向胰胆管内逆行注入4.5%牛磺胆酸钠(1 mL/kg)建立大鼠SAP模型;C组为N-乙酰半胱氨酸(NAC)处理组,术前0.5 h,用NAC(200 mg/kg)腹腔注射,接着建立大鼠SAP模型。于造模术后6 h,麻醉大鼠获取新鲜胰腺和肝脏组织,取一部分用于GSH检测,另一部分用于病理学观察和电镜观察。结果胰腺组织中还原性谷胱甘肽(GSH)水平为:对照组>NAC处理组>SAP组,差异有统计学意义(P<0.05)。胰腺组织病理学检查及评分:SAP组和NAC处理组大鼠出现急性坏死性胰腺炎病变,但NAC处理组胰腺组织坏死比SAP组胰腺组织坏死程度减轻。SAP与NAC处理组比较差异有统计学意义(P=0.0368,P<0.05)。6 h电镜观察:N-乙酰半胱氨酸能改善胰腺腺泡细胞内酶原颗粒运转,肝脏超微结构显示,SAP组内质网扩张,线粒体肿胀,NAC处理组局部可见内质网扩张。结论随着GSH的消耗,发病早期(6 h)就可以出现胰肝损害,补充N-乙酰半胱氨酸能减轻胰腺和肝脏的损害。

The protective effect of glutathione (GSH) on the pancreas and liver injury in rats with early severe acute pancreatitis

Objective To study the protective effect of glutathione(GSH) on the pancreas and liver injury in rats with early severe acute pancreatitis(SAP).Methods 54 male Wistar rats were randomly divided into three groups(n=18): group A,18 male Wistar rats for normal control group,just flip the pancreas after laparotomy,the abdomen was closed;group B,18 male Wistar rats for the SAP group,4.5% sodium taurocholate(1 mL/kg) was retrograded into the pancreatic duct at the rate of 0.1 mL/min;group C,18 male Wistar rats,N-acetylcysteine(NAC) treatment group,half hour before surgery,NAC(200 mg/kg) was given by intraperitoneal injection,followed by the establishment of a rat model of SAP.6 hours after surgery,rats were anesthetized to obtain fresh pancreas and liver tissue,to take part for GSH detection and one for pathological observation and electron microscopy.Results GSH levels in pancreatic tissue: the control group> NAC treated group >SAP group,there were significantly different(P<0.05).Pancreatic histopathological examination and scoring: SAP group and NAC treated group rats occurred acute necrotizing pancreatitis lesions,but the pancreatic necrosis in NAC treatment group lessened than that in the SAP group,there were significantly different between SAP group and NAC treatment group(P=0.0368,P<0.05).Electron microscopy after six hours: N-acetylcysteine could improve the zymogen granules within the pancreatic acinar cell operation.Liver ultrastructure: endoplasmic reticulumed and mitochondrial swellinged in SAP group;partial visible endoplasmic reticulumed in the NAC treatment group.Conclusion With the GSH consumption,the incidence of early(6 hours) can occur the damage of pancreas and liver,supplement of N-acetylcysteine can reduce the damage of the pancreas and liver.