摘要
目的:探讨重症急性胰腺炎(SAP)时急性肾损伤的发病机制及L-精氨酸(L-arg)对其的保护机制.方法:SD大鼠60只制成SAP模型并收集腹水(PAAF);60只制成穿孔性腹膜炎(PP)模型并收集其腹水(PPAF):另将90只随机分为5组:空白组(NS组)、对照组(PPAF组)、模型组(PAAF组)及2个处理组(PAAF+L-arg组和PPAF+L-arg组).观察各组术后12 h的血淀粉酶(Amyl)、尿素氮(BUN)、肌酐(Cr)、血清一氧化氮(NO)及病理学变化,同时检测其肾细胞的凋亡及诱生型一氧化氮合酶(iNOS)的表达情况.结果:PAAF+L-arg组和PPAF+L-arg组的Amyl、BUN、Cr均显著低于PAAF组和PPALF组(Amyl:1925.8±1024.2vs 3328.3±833.3,2128.0±795.9vs 3599.1±1156.9;BUN:9.1±0.9vs 12.4±1.0.8.5±0.8vs 13.0±1.1;Cr:62.1±7.5 vs 114.5±8.6.60.0±6.1 vs 115.8±6.9;P<0.01).而NO及iNOS表达,使用L-arg组最强,依次高于模型组(SAP组及PP组),实验组(PAAF组及PPAF组),而NS组表达最弱.肾细胞的凋亡率SAP组依次高于PAAF组PAAF+L-arg组及NS组;PP组依次高于PPAF组、PPAF+L-arg组及NS组(P<0.01);与肾脏的病理学改变一致.结论:PAAF可以诱导健康大鼠的肾细胞凋亡引起肾损伤以建立稳定的PAAF诱导的健康大鼠肾损伤模型,但该作用可以被小剂量的L-arg阻断.
AIM： To explore the mechanism of acute renal injury in severe acute pancreatitis （SAP） and the effect of the conservative mechanism of L-arginine METHODS： Sixty SAP model rats were estab- fished by retrograde injection of 5% sodium taurocholate into the pancreatic duct and then the PAAF collected for reservation. Another 60 rats were established as perforative peritonitis （PP） models, and their perforative peritonitis associated ascitic fluid （PPAF） was collected. Another ninety SD rats were randomly divided into five groups： NS, PAAF, PPAF, PAAF ＋ L-arg and PPAF ＋ L-arg. Serum concentrations of amylase （Amyl）, urea nitrogen （BUN）, creatinine and nitric oxide were determined at 12 hours post- operation. The renal cell apoptosis rate and inducible nitric oxide synthase activity were examined. Histological observation was performed. RESULTS： The amylase, blood urea nitrogen, and creatinine levels of serum in the PAAF ＋L-arg and PPAF ＋ L-arg groups were lower than those in the PAAF and PPAF groups （Amyl： 1925.8 ± 1024.2 vs 3328.3 ＋ 833.3, 2128.0 ± 795.9 vs 3599.1 ＋ 1156.9; BUN： 9.1 ± 0.9 vs 12.4 ± 1.0, 8.5 ± 0.8 vs 13.0 ＋ 1.1; Cr： 62.1 ± 7.5 vs 114.5 ± 8.6, 60.0 ± 6.1 vs 115.8 ± 6.9; respectively, P 〈 0.01）. The content of nitric oxide and the inducible nitric oxide synthase activity in the SAP group were higher than that in the PAAF group, while they were lower than those in the PAAF ＋ L-arg group, while the NS group was the lowest. Similarly, the PP group was higher than the PPAF group, but lower than the PPAF ＋ L-arg group, while the NS group was, again, the lowest. CONCLUSION： Renal cell apoptosis and injury are induced by pancreatitis associated ascitic fluid and blocked by low doses of L-arginine. A stable renal injury model can be established by PAAF.
出处
《世界华人消化杂志》
CAS
北大核心
2007年第17期1893-1898,共6页
World Chinese Journal of Digestology
作者简介
程若川，教授，主要从事普通外科疾病的临床及基础研究
通讯作者：刘其雨，650032，云南省昆明市西昌路295号，昆明医学院第一附属医院普通外科．liuqiyu_12@hotmail．com电话：0871-5324888-2432
