• 福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院普外科(福建福州 350001);

目的探討重癥急性胰腺炎(SAP)大鼠肝臟毛細(xì)血管滲漏的發(fā)生機(jī)理。方法40只SD大鼠采用完全隨機(jī)法隨機(jī)分為假手術(shù)(sham operation，SO)組和SAP組，SAP按不同的取材時(shí)間又分為3、6、12及24 h 4個(gè)亞組，每組8只。以胰膽管逆行注射5%?；悄懰徕c建立SAP模型，觀察各組肝臟組織病理改變，檢測血清腫瘤壞死因子(TNF)-α水平，干濕重法檢測肝臟組織含水率，免疫組織化學(xué)方法檢測肝臟組織中occludin蛋白表達(dá)水平，RTPCR法檢測肝臟組織中occludin mRNA表達(dá)水平。結(jié)果SO組肝臟組織病理無明顯改變; SAP組肝臟組織表現(xiàn)為典型SAP病理改變，包括血管擴(kuò)張明顯、組織疏松水腫、炎性細(xì)胞浸潤。SAP組各時(shí)相TNF-α水平、肝臟組織含水率逐漸升高，在觀察時(shí)間范圍內(nèi)，24 h時(shí)均達(dá)最高，TNF-α水平、肝臟組織含水率在SAP組不同時(shí)相比較差異均有統(tǒng)計(jì)學(xué)意義(P lt;0.05)，且SAP組不同時(shí)相均明顯高于SO組(P lt;0.05)。SAP 組3 h時(shí)occludin蛋白和mRNA水平均開始降低，6 h時(shí)達(dá)最低值，12 h和24 h時(shí)較6 h時(shí)明顯升高(P lt;0.05)，但仍均低于SO組(P lt;0.05)。結(jié)論SAP大鼠肝臟發(fā)生嚴(yán)重的毛細(xì)血管滲漏，可能與SAP時(shí)TNF-α表達(dá)上調(diào)，導(dǎo)致緊密連接蛋白o(hù)ccludin及其mRNA表達(dá)下調(diào)有關(guān)。

引用本文： 李洪森,黃鶴光. 重癥急性胰腺炎大鼠肝臟毛細(xì)血管滲漏的發(fā)生機(jī)理. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(6): 599-602. doi: 復(fù)制

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6. Jaffray C, Yang J, Norman J. Elastase mimics pancreatitisinduced hepatic injury via inflammatory mediators [J]. J Surg Res, 2000, 90(2): 95101．.
7. Chui DW, Grendell JH. Acute pancreatitis [J]. Curr Opin Gastroenterol, 1993, 9(6): 760766.
8. Fink MP, Delude RL. Epithelial barrier dysfunction: a unifying theme to explain the pathogenesis of multiple organ dysfunction at the cellular level [J]. Crit Care Clin, 2005, 21(2): 177196.
9. Fallon MB, Brecher AR, Balda MS, et al. Altered hepatic localization and expression of occludin after common bile duct ligation [J]. Am J Physiol, 1995, 269(4 Pt 1): C1057C1062.
10. Malminen M, Koivukangas V, Peltonen J, et al. Immunohistological distribution of the tight junction components ZO1 and occludin in regenerating human epidermis [J]. Br J Dermatol, 2003, 149(2): 255260.
11. Kevil CG, Okayama N, Trocha SD, et al. Expression of zonula occludens and adherens junctional proteins in human venous and arterial endothelial cells: role of occludin in endothelial solute barriers [J]. Microcirculation, 1998, 5(23): 197210.
12. Hirase T, Staddon JM, Saitou M, et al. Occludin as a possible determinant of tight junction permeability in endothelial cells [J]. J Cell Sci, 1997, 110(Pt 14): 16031613.
13. Morcos Y, Hosie MJ, Bauer HC, et al. Immunolocalization of occludin and claudin1 to tight junctions in intact CNS vessels of mammalian retina [J]. J Neurocytol, 2001, 30(2): 107123.
14. Panek J, Zasada J, Po＇zniczek M. Microcirculatory disturbance in the course of acute pancreatitis [J]. Przegl Lek, 2007, 64(6): 435437.
  1. 1. 楊波, 黃鶴光, 陳大良, 等. 逆行性胰膽管注射法制作重癥急性胰腺炎大鼠模型 [J]. 福建醫(yī)科大學(xué)學(xué)報(bào), 2002, 36(1): 7172.
  2. 2. 陳德招, 黃鶴光. 羥乙基淀粉(130/0.4)對(duì)急性壞死性胰腺炎大鼠腦毛細(xì)血管滲漏的影響 [J]. 中華胰腺病雜志, 2010, 10(3): 213214.
  3. 3. Kingsnorth A. Role of cytokines and their inhibitors in acute pancreatitis [J]. Gut, 1997, 40(1): 14.
  4. 4. Karne S, Gorelick FS. Etiopathogenesis of acute pancreatitis [J]. Surg Clin North Am, 1999, 79(4): 699710．.
  5. 5. 藤澤林. 非手術(shù)治療重癥急性胰腺炎23例報(bào)告 [J]. 新醫(yī)學(xué), 2001, 32(5): 285286．.
  6. 6. Jaffray C, Yang J, Norman J. Elastase mimics pancreatitisinduced hepatic injury via inflammatory mediators [J]. J Surg Res, 2000, 90(2): 95101．.
  7. 7. Chui DW, Grendell JH. Acute pancreatitis [J]. Curr Opin Gastroenterol, 1993, 9(6): 760766.
  8. 8. Fink MP, Delude RL. Epithelial barrier dysfunction: a unifying theme to explain the pathogenesis of multiple organ dysfunction at the cellular level [J]. Crit Care Clin, 2005, 21(2): 177196.
  9. 9. Fallon MB, Brecher AR, Balda MS, et al. Altered hepatic localization and expression of occludin after common bile duct ligation [J]. Am J Physiol, 1995, 269(4 Pt 1): C1057C1062.
  10. 10. Malminen M, Koivukangas V, Peltonen J, et al. Immunohistological distribution of the tight junction components ZO1 and occludin in regenerating human epidermis [J]. Br J Dermatol, 2003, 149(2): 255260.
  11. 11. Kevil CG, Okayama N, Trocha SD, et al. Expression of zonula occludens and adherens junctional proteins in human venous and arterial endothelial cells: role of occludin in endothelial solute barriers [J]. Microcirculation, 1998, 5(23): 197210.
  12. 12. Hirase T, Staddon JM, Saitou M, et al. Occludin as a possible determinant of tight junction permeability in endothelial cells [J]. J Cell Sci, 1997, 110(Pt 14): 16031613.
  13. 13. Morcos Y, Hosie MJ, Bauer HC, et al. Immunolocalization of occludin and claudin1 to tight junctions in intact CNS vessels of mammalian retina [J]. J Neurocytol, 2001, 30(2): 107123.
  14. 14. Panek J, Zasada J, Po＇zniczek M. Microcirculatory disturbance in the course of acute pancreatitis [J]. Przegl Lek, 2007, 64(6): 435437.