大鼠急性胰腺炎反应中脾脏对肠屏障功能的影响
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鲁正

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Effect of the spleen on intestinal barrier function in rats with acute pancreatitis
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    摘要:

    摘要:
    目的 探讨脾脏在大鼠急性胰腺炎(AP)病程中对肠屏障功能的影响。
    方法 随机将大鼠分成4组:假手术组,AP组,脾切除组,脾切除+AP组。手术后24h检测各组血清TNFα,IL1β,IL6及IL10水平,术后2d测肠细菌移位率,并取末段回肠行光镜及透射电镜观察肠黏膜受损情况。
    结果 脾切除+AP组TNFα,IL1β,IL6及IL10值分别为3.06±3.61,16.46±5.52,19.90±6.89,6.94±3.93;AP组的测得值分别为19.93±2.38,42.79±4.31,20.19±3.35,39.28±12.69。脾切除+AP组TNFα,IL1β及IL10的值显著低于AP组(P<0.05),脾切除+AP组细菌移位率为40%显著低于AP组93.3%(P<0.05)。脾切除+AP组肠黏膜上皮仅轻微水肿,肠黏膜基本完整,而AP组肠黏膜上皮水肿明显,绒毛坏死,上皮细胞变性,炎性细胞浸润及细菌移位。
    结论 脾脏在急性炎症反应中,可明显促进炎性介质的产生和释放,加重炎症反应。脾脏切除后可减少促炎因子的产生和释放,肠黏膜受损减轻,细菌移位率下降。

    Abstract:

    Abstract:Objective
    To investigate the effect of the spleen on the function of intestinal barrier during the course of acute pancreatitis in rats.
    Methods Rats were randomly divided into four groups: sham operation group; actue pancreatitis group; splenectomy group;splenectomy plus acute pancreatitis group.The serum levels of TNFα,IL1,IL6 and IL10 in each group were examined 24 hours after operation.Two days after operation,the rate of bacterial translocation(BT) was determined and the terminal ileum was excised and examined by transmission electron microscopy to detect the injury of intestinal mucosa.
    Results The serum levels of TNFα,IL1β,IL6 and IL10 in splenectomy plus acute pancreatitis group were 3.06±3.61,16.46±5.52,19.90±6.89,6.94±3.93,and in acute pancreatitis group were 19.93±2.38, 42.79±4.31, 20.19±3.35, 39.28±12.69 respectively. The values of TNFα, IL1β and IL10 were significantly lower in splenectomy plus acute pancreatitis group than those in acute pancreatitis group(P<0.05).The rate of bacterial translocation was 40 percent in splenectomy plus acute pancreatitis group,but 93.3 percent in acute pancreatitis group,and the difference was statistically significant(P<0.05).Histologic examination revealed mild edema of intestinal mucosal epithelium and normally appearing intact mucosa in splenectomy plus acute pancreatitis group,whereas in acute pancreatitis group revealed severe injuries of intestinal mucosa,including apparent edema,necrosis of intestinal villi,degeneration of epithelial cells,infiltration of neutrophils and bacterial translocation. 〖WTHZ〗Conclusions The spleen can exacerbate the inflammatory response of acute pancreatitis by markedly promoting the production and release of inflammatory mediators. Splenectomy can reduce the production and release of inflammatory mediators, and thus decrease the damage of intestinal mucosa and the rate of BT.

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鲁正 ,朱言亮 ,何长林 ,刘金新.大鼠急性胰腺炎反应中脾脏对肠屏障功能的影响[J].中国普通外科杂志,2005,14(5):4-.
DOI:10.7659/j. issn.1005-6947.2005.05.003

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  • 收稿日期:2004-06-08
  • 最后修改日期:2005-02-28
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  • 在线发布日期: 2005-05-25