【關鍵詞】 危重病；急性病；胰腺炎；肺/損傷；細胞凋亡；DDFA
【Abstract】 AIM: To explore the effects of DDFA on cell apoptosis and expressions of Bax and Bcl2 in lung tissue of rats with severe acute pancreatitis(SAP). METHODS: 45 rats weighting 200250 g were randomized into 3 groups: control group (n=15), SAP group (n=15) and DDFA group (n=15). The models of SAP were established by the injection of 200 g/L arginine solution ip（once a hour for 2 h） into the rats. At the 24, 48 and 72 h after establishment of models, serum amylase, TNFa and calcium were determined. The left lungs were taken for light and electron microscopic observation. Cell apoptosis in lung tissue was determined by TUNEL method. Expressions of Bax and Bcl2 were detected by immunohistochemical staining of SABC. RESULTS: In the SAP group, serum amylase, TNFa, apoptotic index, expressions of Bax and Bcl2 markedly increased. Lung tissue injuries were significant under a light microscope. As compared with SAP group at the same phase, serum amylase, TNFa, apoptotic index and expressions of Bax in DDFA group decreased significantly. While the expression of Bcl2 increased significantly. The injury of lung tissue was relieved by DDFA. CONCLUSION: The apoptosis and the expressions of Bax and Bcl2 in lung tissue might be involved in pathogenesis of SAP. DDFA administration in the early stage is helpful for diminishing lung injury induced by SAP.
【Keywords】 critical illness; acute disease; pancreatitis; lung/injuries; apoptosis; DDFA
【摘要】 目的： 探討DDFA對重症急性胰腺炎(SAP)大鼠肺組織內細胞凋亡及Bax,Bcl2基因表達的影響. 方法： 大鼠45只隨機分爲對照組（CG）， SAP組和DDFA治療組，每組15只. 大鼠SAP模型採用分2次ip 200 g/L精氨酸溶液方法建立，建模後24, 48和72 h時測定血清TNFa，澱粉酶. 血鈣及光鏡觀察肺組織病理變化，細胞凋亡原位檢測(TUNEL)法測定肺組織內細胞凋亡，SABC免疫組化染色法測定肺組織Bax, Bcl2基因表達. 結果： SAP組血清澱粉酶, TNFa和肺組織內細胞凋亡指數, Bax, Bcl2基因表達較CG組升高，光鏡下見肺組織損害明顯；經DDFA治療後，血清澱粉酶, TNFa和肺組織內細胞凋亡指數, Bax基因表達下降，而Bcl2基因表達增強，光鏡下見肺組織損害減輕. 結論： 肺組織細胞凋亡, Bax, Bcl2基因表達參與SAP發病機制，在SAP早期給予DDFA治療對減輕肺臟損害是有益的..
【關鍵詞】 危重病；急性病；胰腺炎；肺/損傷；細胞凋亡；DDFA
0引言
重症急性胰腺炎(severe acute pancreatitis, SAP)常併發多器官功能障礙，其胰外器官損傷中肺損傷最爲常見，稱之爲： 急性胰腺炎相關性肺損傷［1］，其發病機制尚不完全清楚. 1997年方馳華等［2］應用DDFA方案(D： dexamethasone； D： dextran； F： 5Fluorouracil； A： Appotininum)治療SAP取得明顯效果. 我們利用SAP肺臟損害大鼠模型，探討細胞凋亡和Bax, Bcl2基因表達在SAP肺臟損害發病機制中的作用以及應用DDFA治療後的影響.
1材料和方法
1.1材料SD大鼠45只，雌雄不限，體質量2
