探讨重症急性胰腺炎大鼠肺损伤与肠道屏障损伤的相关性及中药清胰汤的保护作用。方法:40只SD大鼠随机分为假手术组、模型组、清胰汤组和地塞米松组,真空干燥法测肺湿干比值,生化分析仪测血氧分压及淀粉酶含量,化学法测肺、肠组织中sPLA2的活性,TUNEL法测肠黏膜上皮细胞凋亡情况。结果:模型组大鼠血清淀粉酶含量(7208.8±264.6)U/L高于假手术组(1358.8±458.2)U/L,P0.05,模型组血TNF-α含量(180.53±20.1)ng/L,高于假手术组(59.67±14.3)ng/L,P0.05,模型组肺湿干比值(5.394±0.44)高于假手术组(3.866±0.34),P0.05,模型组肠黏膜上皮细胞凋亡指数(0.256±0.06)高于假手术组(0.046±0.02),P0.05,模型组血氧分压(54.56±7.78)mmHg低于假手术组(101.22±2.67)mmHg,P0.05,模型组较假手术组肺和肠组织中sPLA2活性明显升高,二者呈正相关关系(r=0.79,P0.05);清胰汤组、地塞米松组较模型组大鼠胰腺、肺和肠组织损伤程度明显减轻。结论:重症急性胰腺炎时肺损伤与肠道屏障损伤间存在明显的正相关关系,清胰汤可以降低sPLA2的活性,对胰、肺和肠组织起保护作用。
Objective To observe the relationship of lung and intestine barrier injury in rats of severe acute pancreatitis (SAP) and to excavate the therapeutic action of traditional Chinese medicine Qingyi decoction (清胰汤). Methods Forty healthy Spraghe-Dawley rats were randomly divided into sham operation, SAP, Qin-gyi decoction and Dexamethasone groups. Serum amylase,blood gas analysis,lung tissue W/D and lung tissue W/D were measured to evaluate the severity of pancreatitis and (acute lung injury ALI). (secreted phospholipase A2 sPLA2) activity of lung and intestine was measured by chemical method. The apoptosis of intestinal mucosal epi-thelial cells were used by TUNEL method. Results Compared with the sham group, the lung injury was seri-ous in SAP group as evidenced by the results of serum amylase (7208.8 ± 264.6 U/L vs 1358.8 ± 458.2 U/L, P<0.05) , TNF-α concentration (180.53 ± 20.1 vs 59.67 ± 14.3 ng/L, P<0.05), lung tissue W/D (5.394 ± 0.44 vs 3.866 ± 0.34, P<0.05) an