高甘油三酯血症在急性胰腺炎病程中对急性肾损伤的作用及动物模型

The role of hypertriglyceridemia for acute kidney injury in the course of acute pancreatitis and an animal model.

作者信息

Wu Congye, Zou Lei, Shi Shujing, Tong Zhihui, Shen Xiao, Yang Dongliang, Ke Lu, Li Weiqin, Li Jieshou

机构信息

Department of SICU, Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China; Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Department of SICU, Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China.

出版信息

Pancreatology. 2017 Jul-Aug;17(4):561-566. doi: 10.1016/j.pan.2017.06.006. Epub 2017 Jun 12.

DOI:10.1016/j.pan.2017.06.006

PMID:28647101

Abstract

OBJECTIVE

The aim of this study was to investigate the role of hypertriglyceridemia for acute kidney injury (AKI) in the course of acute pancreatitis.

METHODS

Patients with acute pancreatitis were retrospectively divided into four groups according to admission triglyceride: normal group, mild HTG group, moderate HTG group and severe HTG group. Clinical characteristics were compared among these groups. Wild type (WT) mice and Human ApoC III transgenic (ApoCIIItg) mice were used in the next animal experiments. Severe acute pancreatitis (SAP) model was established by retrograde injection of 0.5% sodium taurocholate (0.1 ml/100 g) from duodenum to pancreatic duct. Histological scores, serum amylase, creatinine, usea nitrogen were compared between WT mice and ApoCIIItg mice.

RESULTS

Two hundred and sixty-two patients were classified into 4 groups: normal TG (104, 39.7%), mild HTG (72, 27.5%), moderate HTG (47, 17.9%), and severe HTG (39, 14.9%) groups. The proportions of AKI were 13.5% (14/104, normal), 13.9% (10/72, mild), 21.3% (10/47, moderate), and 38.5% (15/39, severe), respectively. After establishing SAP model, the levels of serum amylase (P < 0.05) and pancreatic histological score (P < 0.05) of ApoCIII-SAP-9h group were significantly higher than that of WT-SAP-9h group, respectively. ApoCIII-SAP-9h group had significantly higher levels of serum creatinine (P < 0.001), usea nitrogen (P < 0.001), and kidney histological score (P < 0.05) than that of WT-SAP-9h group, respectively.

CONCLUSIONS

Mild HTG has little adverse impact on disease severity of acute pancreatitis; severe HTG can aggravate kidney injury in the course of acute pancreatitis. ApoCIII-SAP mice have more serious pancreatic damage and kidney injury than WT-SAP mice.

摘要

目的

本研究旨在探讨高甘油三酯血症在急性胰腺炎病程中对急性肾损伤（AKI）的作用。

方法

将急性胰腺炎患者根据入院时甘油三酯水平回顾性分为四组：正常组、轻度高甘油三酯血症（HTG）组、中度HTG组和重度HTG组。比较这些组的临床特征。接下来的动物实验使用野生型（WT）小鼠和人载脂蛋白C III转基因（ApoCIIItg）小鼠。通过从十二指肠向胰管逆行注射0.5%牛磺胆酸钠（0.1 ml/100 g）建立重症急性胰腺炎（SAP）模型。比较WT小鼠和ApoCIIItg小鼠的组织学评分、血清淀粉酶、肌酐、尿素氮。

结果

262例患者分为4组：正常甘油三酯（TG）组（104例，39.7%）、轻度HTG组（72例，27.5%）、中度HTG组（47例，17.9%）和重度HTG组（39例，14.9%）。AKI的比例分别为13.5%（14/104，正常）、13.9%（10/72，轻度）、21.3%（10/47，中度）和38.5%（15/39，重度）。建立SAP模型后，ApoCIII-SAP-9h组的血清淀粉酶水平（P<0.05）和胰腺组织学评分（P<0.05）分别显著高于WT-SAP-9h组。ApoCIII-SAP-9h组的血清肌酐水平（P<0.001）、尿素氮水平（P<0.001）和肾脏组织学评分（P<0.05）分别显著高于WT-SAP-9h组。