本文選題：重癥急性胰腺炎 + 置管引流　； 參考：《重慶醫(yī)科大學》2013年碩士論文

【摘要】：目的通過對重癥急性胰腺炎（Severe acute pancreatitis,SAP）模型大鼠進行腹腔置管引流，探討其對胰腺腺泡細胞內鈣超載機制的作用。 方法將72只雄性Wistar大鼠隨機分為假手術組、SAP組和引流組，，各24只，后兩組采用“經十二指腸逆行胰膽管注射牛磺膽酸鈉”法誘導SAP大鼠模型，后對引流組進行腹腔置管引流出腹水，三組大鼠分別在術后6h、12h、24h定點處死，每個時間點8只，取靜脈血和腹水檢測白細胞介素(Interleukin,IL)-8、腫瘤壞死因子（Tumornecrosis factor,TNF）-ɑ、血栓素（Thromboxane,Tx）A_2等炎性因子和淀粉酶（Amylase,AMY）、磷脂酶((Phospholipase,PL)A_2的活性等，取胰腺組織檢測腺泡細胞內[Ca~(2+)]i和HE染色病理切片。 結果引流組在6h、12h、24h三個時相點的血清IL-8、TNF-ɑ、AMY、TxA_2、胰腺組織PLA_2活性和腺泡細胞內[Ca~(2+)]i相比SAP組都有明顯降低（P0.05），SAP組和引流組都呈典型的SAP病理改變,但引流組的病理評分較SAP組顯著減少（P0.05）。 結論對SAP大鼠進行腹腔置管,引流出IL-8、TNF-ɑ等炎性因子，降低了胰腺組織中PLA_2的活性以及血清IL-8、TNF-ɑ、TxA_2、LT等的濃度，減輕了胰腺損傷，這可能和胰腺腺泡細胞內的鈣超載緩解有關。
[Abstract]:Objective to investigate the mechanism of calcium overload in pancreatic acinar cells by intraperitoneal drainage in severe acute pancreatitis (SAP) model rats with severe acute pancreatitis (SAP). Methods Seventy-two male Wistar rats were randomly divided into sham-operation group (n = 24) and drainage group (n = 24). SAP rats were induced by injection of sodium taurocholate into duodenal retrograde pancreaticobiliary duct in the latter two groups. The rats in the three groups were killed at 24 hours after the operation, 8 rats at each time point. The levels of interleukin-8, Tumornecrosis factor (Tumornecrosis factor), Thromboxane TxA2, amylase Amylase and phospholipase PLA2 were measured in venous blood and ascites. The pancreatic tissues were taken to detect the Ca~(2 in acinar cells and the histopathological sections with HE staining. Results in the drainage group, the serum IL-8 TNF-AMYYTxA2was significantly lower than that in the SAP group at three phases at 6 h, 12 h and 24 h. Compared with the SAP group, both the pancreatic tissue PLA_2 activity and the acinar cell [Ca~(2] I showed typical SAP pathological changes. However, the pathological score of the drainage group was significantly lower than that of the SAP group, but the pathological score of the drainage group was significantly lower than that of the SAP group, and the pathological score of the drainage group was significantly lower than that of the SAP group. Conclusion Intraperitoneal catheterization was performed in SAP rats, and inflammatory factors such as IL-8 TNF-T were drained out, which decreased the activity of PLA_2 and the concentration of serum IL-8 TNF-TxA2LT in pancreatic tissue, and alleviated pancreatic injury, which may be related to the relief of calcium overload in pancreatic acinar cells.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R657.51

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