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重症急性胰腺炎大鼠模型的早期腹腔引流与灌洗

Early-phase peritoneal drainage and lavage in a rat model of severe acute pancreatitis.

作者信息

Zhu Leiming, Lu Jilin, Yang Jing, Sun Peng

机构信息

Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, China.

Department of General Surgery, No. 1 Hospital, Shanghai Jiao Tong University School of Medicine, 85 Wujin Road, Shanghai, 200080, China.

出版信息

Surg Today. 2016 Mar;46(3):371-8. doi: 10.1007/s00595-015-1172-9. Epub 2015 Apr 21.

Abstract

PURPOSE

To evaluate the effects of early-phase drainage on the survival rates and pancreatic pathological changes associated with severe acute pancreatitis (SAP) in a rat model.

METHODS

Sprague-Dawley rats were divided into the following groups: SAP model (control), early drainage and delayed drainage. The 24-h survival rates were compared among the groups. In addition, the serum and ascites concentrations of interleukin (IL)-1β, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α were measured, and pancreatic pathological changes were observed.

RESULTS

The survival rate significantly improved in the early drainage group. Compared with that observed in the control group, the serum TNF-α and IL-8 concentrations in the early drainage group decreased, while the serum IL-10 levels increased, and the ascites concentrations of IL-1β, IL-6, IL-8 and TNF-α decreased, while that of IL-10 increased significantly. In the delayed drainage group, only the ascites concentrations of TNF-α decreased. Meanwhile, the pancreatic pathological changes at 3, 6 and 24 h worsened in the early drainage group; however, the pancreatic lesions in the early drainage group were less mild than those seen in the control group.

CONCLUSIONS

Rebalancing the cytokine levels in ascites after early drainage may be a key factor for enhancing the survival rate in rats.

摘要

目的

在大鼠模型中评估早期引流对重症急性胰腺炎(SAP)生存率及胰腺病理变化的影响。

方法

将Sprague-Dawley大鼠分为以下几组:SAP模型组(对照组)、早期引流组和延迟引流组。比较各组24小时生存率。此外,检测血清和腹水中白细胞介素(IL)-1β、IL-6、IL-8、IL-10和肿瘤坏死因子(TNF)-α的浓度,并观察胰腺病理变化。

结果

早期引流组生存率显著提高。与对照组相比,早期引流组血清TNF-α和IL-8浓度降低,血清IL-10水平升高,腹水IL-1β、IL-6、IL-8和TNF-α浓度降低,而IL-10浓度显著升高。在延迟引流组,仅腹水TNF-α浓度降低。同时,早期引流组在3、6和24小时时胰腺病理变化加重;然而,早期引流组胰腺病变比对照组轻。

结论

早期引流后腹水细胞因子水平的重新平衡可能是提高大鼠生存率的关键因素。

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