他克莫司对重症急性胰腺炎大鼠肺损伤的治疗作用
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窦科峰

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The therapeutic effect of tacrolimus against the lung injuries induced by severe acute pancreatitis in rats
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    摘要:

    目的:观察他克莫司(Tacrolimus,FK506)对重症急性胰腺炎(SAP)大鼠肺损伤的潜在治疗作用并探究其机制。
    方法:健康雌性SD大鼠54只,随机分为对照组(C组)、SAP组(S组)、SAP+ Tacrolimus治疗组(ST组)。检测3组大鼠术后3,6,12 h血清肿瘤坏死因子α(TNF-α)及基质金属蛋白酶9(MMP-9)水平、支气管肺泡灌洗液(BALF)蛋白含量、肺组织髓过氧化物酶(MPO)活性,并计算存活率,观察肺组织及胰腺组织的病理变化。
    结果:S组血清TNF-α及MMP-9水平和BALF蛋白含量及肺组织髓过氧化物酶(MPO)活性均较对照组显著升高(P<0.01);与S组比较,ST组12 h后上述指标均明显降低[TNF-α:(171.31±19.58)vs(243.17±26.19);MMP-9:(1 658.32±27.49)vs(2 987.34±34.53);MPO:(2.75±0.22)vs(11.27±0.49); BALF:(631.58±57.25)vs(1 987.39±158.34)](均P<0.01),ST组存活率高于S组(P<0.01)。组织病理切片提示S组胰腺、肺组织损伤随病情进展而逐渐加重;ST组较S组减较。
    结论:Tacrolimus可有效降低SAP大鼠肺损伤的严重程度,能提高其存活率,对SAP有一定的治疗作用。其机制可能与减少肺脏的毛细血管渗透性、抑制中性粒细胞(PMN)释放MPO和MMP-9及抑制TNF-α等炎症介质的释放有关。

    Abstract:

    Abstract:Objective:To observe the potential therapeutic effect of tacrolimus against lung injuries induced by severe acute pancreatitis(SAP) in rats and investigate its mechanism.
    Methods :Fifty-four female SD rats were randomly divided into 3 groups: Control group(group C), SAP group(group S) and SAP+ tacrolimus treatment group(group ST) (n=18 each group). Serum levels of tumor necrosis factor-alpha(TNF-α) and matrix metalloproteinase-9(MMP-9), myeloperoxidase(MPO) activity of lung tissue and the protein content of bronchoalveolar lavage fluids(BALF) were evaluated 3,6, and 12h after operation. The survival rates of 3 groups were also evaluated, and histopathologic changes of lung and pancreas were observed.
    Results:In group S, serum level of TNF-α and MMP-9, MPO activity of lung tissue, and the protein content of BALF were significantly increased than those in group C (all P<0.01). All the indicators of group ST were significantly decreased 12h after operation as compared with group S [TNF-α:(171.31±19.58)vs(243.17±26.19);MMP-9:(1 658.32±27.49)vs(2 987.34±34.53);MPO:(2.75±0.22)vs(11.27±0.49); BALF:(631.58±57.25)vs(1 987.39±158.34)] (P<0.01). Histopathology showed that the lung and pancreas injuries in group S were gradually aggravated with disease progression, and alleviated obviously with tacrolimus treatment.
    Conclusions:Tacrolimus can relieve the severity of lung injuries of pancreatitis rats, increase survival rate, and provide a certain therapeutic effect for SAP rats. The mechanism of tacrolimus effect may be related to the reduction of lung blood capillary permeability, and the inhibition of serum level of TNF-α and MMP-9, lung MPO, and other inflammatory factors.

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刘建华, 赵青川, 窦科峰, 蔡文科, 李丙所, 党军强, 王江, 张福琴.他克莫司对重症急性胰腺炎大鼠肺损伤的治疗作用[J].中国普通外科杂志,2008,17(3):3-213.
DOI:10.7659/j. issn.1005-6947.2008.03.003

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  • 在线发布日期: 2008-03-25