摘要
目的观察重症急性胰腺炎(SAP)血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL- 6)、血清钙和甲状旁腺激素受体(PTHR)的表达水平及相互关系,探讨甲强龙干预后的变化。方法将SD大鼠36只随机分为3组,假手术组(SO)、SAP组、SAP甲强龙治疗组(SAP+MP)各12只, 以5％牛磺脱氧胆酸钠逆行胰胆管注射建立SAP模型,观察各组血清钙、淀粉酶、TNF-α、IL-6、腹水量和胰腺病理改变,逆转录-聚合酶链反应(RT-PCR)分析肾脏和骨组织PTHR mRNA表达水平。结果 SAP组制模后血清TNF-α、IL-6升高,而肾脏和骨PTHR mRNA表达下调(P<0．01),血清钙显著降低,以12 h最为明显;血清TNF-α、IL-6与血清钙、肾脏和骨PTHR mRNA表达水平呈负相关。与SAP组比较,SAP+MP组血清TNF-α、IL-6水平明显下降,而PTHR mRNA表达上调 (P<0．01),低钙血症和胰腺局部的病理改变得到改善,存活率显著提高。结论肾脏和骨组织 PTHR mRNA表达下调是SAP低钙血症的重要原因之一,可能与炎症细胞因子的过度释放有关。甲强龙可抑制炎症细胞因子的释放,提高PTHR mRNA表达水平,改善低钙血症。
Objective To study the serum levels of tumor necrosis factor （TNF-α）, interleukin 6 （IL-6）, serum calcium and the expression of parathyroid hormone receptor （PTHR） in rats with severe acute pancreatitis （SAP）, and to investigate the changes after methylprednisolone intervention. Methods Thirty-six male SD rats were divided randomly into three groups： sham operation group （SO）, SAP group and SAP methylprednisolone treatment group （SAP ＋ MP）, 12 rats in each group. SAP model was made by injecting 5 % sodium deoxycholate into biliary-pancreatic duct. Serum calcium, amylase, TNF-α, IL-6, volume of ascites and histological change of pancreas were determined. The expression of PTHR mRNA in the rat kidney and bone was detected by RT-PCR. Results The serum TNF-α and IL-6 levels in SAP group were significantly increased after SAP onset. Meanwhile, the expression of PTHR mRNA in the rat kidney and bone was decreased （P 〈 0.01）, and the concentration of serum calcium remarkably reduced, especially 12 h after SAP onset. The levels of serum TNF-α and IL-6 had a negative correlation to the concentration of serum calcium and the expression of PTHR mRNA. As compared with SAP group, the levels of serum TNF-α and IL-6 were significantly decreased and the expression of PTHR mRNA elevated （P〈0.01） in SAP ＋ MP group. The hypoealeemia was significantly alleviated, the pancreatic pathological changes attenuated, and the survival rate increased. Conclusion The decreased expression of PTHR mRNA in kidney and bone is one of the vital causes of hypocaleemia in SAP, probably through the excessive release of inflammtory cytokines. Methylprednisolone can inhibit the release of inflammatory cytokines, increase the expression of PTHR mRNA and improve hypocalcemia.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2006年第4期567-569,共3页
Chinese Journal of Experimental Surgery
基金
福建省教育厅科研基金资助项目(JA03099)
