王代宏参附注射液对大鼠重症急性胰腺炎肾损伤的影响修改稿.doc

参附注射液对大鼠重症急性胰腺炎肾损伤的影响 王代宏 王伟 王芳元 咸宁市中心医院普外科（437100） 摘要：目的 观察参附(SF)注射液对重症急性胰腺炎(SAP)肾损伤的影响。方法 将SD大鼠40只随机分为SAP组和SF组,每组20只,SAP模型制作采用4%牛磺胆酸钠溶液逆行注射胰管内的方法,动态测定血浆BUN、Cr和TNF-α、IL-6、LPS、ATⅡ水平，观察胰腺和肾脏的病理学变化。结果 制模后SAP组血浆TNF-α、IL-6 、LPS、ATⅡ水平升高,SF组血浆TNF-α、IL-6 、LPS、ATⅡ水平明显降低，胰腺和肾脏的病理改变明显减轻，肾功能明显改善，24h后改变更为明显。结论 细胞因子、内毒素和肾素—血管紧张素系统的激活参与了SAP肾损伤的发生发展过程，参附注射液降低免疫炎性反应和内毒素，减轻胰腺炎和肾损伤。 关键词：胰腺炎；肾损伤；参附 Effects of Shen-Fu Injection on kidney Injury in severe acute pancreatitis rats WANG Dai-Hong，WANG Wei, WANG Fang-Yuan Department of General Surgery，XianNing Central Hospital, XianNing 437100, China Abstract: objective To expore the protective effects of Shenfu injection(SF) on kidney Injury in severe acute pancreatitis rats. Methods SD rats were divided randomly into SAP group (n=20) and SF group (n=20). SAP animal model was devoloped in adult male rats by retrograde injection of 4% sodium taurocholate 1ml/kg in biliopancreatiic duct。The plasma levels ofBUN、Cr and TNF-a, IL-6 , LPS, ATⅡ were measured at various time points.Morphology of pancreas and kidney were observed. Results The plasma levels of TNF-a, IL-6 , LPS and ATⅡ elevated significantly after SAP induction. Compared with SAP group, the plasma levels of TNF-a, IL-6 , LPS and ATⅡgradually decreased, the renal function were improved, histological changes of pancreas and kidney were also relieved. The change was significant after hour 24. Conclusions Cytokines, LPS, and activated rennin-angiotensin system might be involved in pathogenesis of the kidney injury following SAP. Shenfu injection could modulate immunity function, relieve the toxicity action of LPS, and alleviate pancreatitis and kidney injury . Key Word: Pancreatitis; Kidney injury ; Shenfu injection 重症急性胰腺炎（Severe acute pancreatitis、SAP）早期可引起多器官功能障碍综合征（MODS）的发生。在胰腺外脏器损伤中，肾损伤的发生率仅次于肺损伤。我们通过制作大鼠重症急性胰腺炎模型，动态观察血浆细胞因子、内毒素、血管紧张素Ⅱ的变化和胰腺、肾脏的病理学改变，探讨参附注射液对SAP并发肾损伤的影响及可能机制。 1、材料与方法 1.1 材料： 雄性健康SD大鼠40只，体重200-250g，牛磺胆酸钠由Sigma公司提供，鲎试剂盒购自上海市医学化研所，TNF-α和IL-6 ELISA试