【摘要】：目的觀察腎上腺髓質素（ADM）在急性壞死性胰腺炎（ANP）并肝、腎損傷大鼠肝、腎組織中的表達情況，觀察ADM在血清內含量的變化情況，探討ADM與ANP及其合并的肝、腎損傷的關系。 方法將64只SD大鼠隨機分為ANP模型組（A組，n=32）和假手術對照組（C組，n=32）。A組采用經十二指腸乳頭逆行胰膽管注射5%牛磺膽酸鈉誘導大鼠ANP并肝、腎損傷模型。C組僅開腹后輕輕翻動胰腺。每組再分為3h、6h、12h、24h四個實驗小組，每個實驗小組8只SD大鼠，在術后對應時點分批處死，，取胰腺、肝及腎組織在光鏡下進行組織病理學檢查及病理學評分。分裝血清分別應用底物酶法檢測淀粉酶（AMS）、丙氨酸氨基轉移酶（ALT）、天門冬氨酸氨基轉移酶（AST），應用ELISA法檢測血清ADM濃度。應用熒光定量PCR法檢測肝、腎組織內ADM mRNA的表達。應用免疫組化法檢測肝、腎組織內ADM蛋白的表達情況。 結果A組大鼠胰腺病理損傷逐漸加重，病理評分逐漸增高，24h為最高值，各時點均顯著高于同時點C組（P＜0.01）。A組肝臟病理評分于造模后3h開始增高，12h達峰值，各時點均高于同時點C組（P＜0.01）。A組腎臟病理評分逐漸增高，24h為最高值，各時點均高于同時點C組（P＜0.05）。A組血清AMS與AST水平于造模后3h開始升高，6h達峰值，各時點均顯著高于同時點C組（P＜0.05, P＜0.01）。A組血清ALT水平逐漸升高，24h為最高值，各時點均高于同時點C組（P＜0.05）。A組血清ADM水平于造模后3h上升，12h達峰值，各時點均高于同時點C組（P＜0.05）。A組肝組織ADMmRNA表達于造模后3h升高，6h達峰值，各時點均高于同時點C組（P＜0.05）。A組腎組織ADM mRNA表達于造模后12h內升高不明顯，隨著時間延長而緩慢上升，造模后24h為最高值，高于同時點C組（P＜0.01)。A組肝組織于造模后3h開始出現ADM蛋白強陽性表達，24h為最高值，在3h、12h、24h時高于同時點C組（P＜0.05）。A組腎組織于造模后3h開始出現ADM蛋白強陽性表達，6h達峰值，并一直保持在高水平，各時點均高于同時點C組（P＜0.05）。 結論ANP大鼠血清ADM水平升高可能與疾病嚴重程度有關，ADM在ANP大鼠肝、腎組織的表達增高可能與ANP合并的肝、腎損傷的嚴重程度有關。
[Abstract]:Objective to observe the expression of adrenomedullin (ADM) in the liver and kidney of rats with acute necrotizing pancreatitis (ANP) and renal injury, to observe the changes of ADM in serum, and to explore the relationship between ADM and ANP and their combined liver, and to observe the expression of adrenomedullin in liver and kidney of rats with acute necrotizing pancreatitis. The relationship between renal injury and renal injury. Methods Sixty-four SD rats were randomly divided into ANP model group (group A, n = 32) and sham-operated control group (group C, n = 32). ANP and liver were induced by retrograde injection of 5% sodium taurocholate into the duodenal papillary cholangiopancreatic duct in group C (n = 32). Renal injury model. Group C only slightly flipped the pancreas after laparotomy. Each group was divided into four groups (3 h, 6 h, 12 h, 24 h). Eight SD rats in each group were killed at the corresponding time point after operation. The pancreas, liver and kidney tissues were taken for histopathological examination and pathological score under light microscope. Serum (AMS), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), were detected by substrate enzyme method and serum ADM concentration was determined by ELISA method. The expression of ADM mRNA in liver and kidney was detected by fluorescence quantitative PCR. Immunohistochemical method was used to detect the expression of ADM protein in liver and kidney. Results the pathological injury of pancreas in group A was gradually aggravated, and the pathological score was gradually increased, the highest value was at 24 h, which was significantly higher than that in group C at the same time point (P < 0 01). The liver pathological score of group A was increased at 3 h after modeling, and reached the peak at 12 h after the establishment of the model (P < 0 01). The levels of serum AMS and AST in group C were significantly higher than those in group C at all time points (P < 0.01), and the renal pathological scores in group C were higher than those in group C at 24 hours (P < 0.01). The levels of serum AMS and AST in group C were significantly higher than those in group C at the same time (P < 0.05). A, P < 0.05). The levels of serum ALT in group C were significantly higher than those in group C at 6 h (P < 0.05, P < 0.01), and the highest level of serum ALT was at 24 h in group C (P < 0.05, P < 0.01). The levels of serum ADM in group C were higher than those in group C at the same time point (P < 0.05), the level of serum ADM in group). A increased at 3 h, reached the peak at 12 h, and the expression of ADMmRNA in liver tissue of group C at the same time point was higher than that in group C (P < 0.05). A) at 3 h after modeling. At 6 h, the expression of ADM mRNA in renal tissue of group C was higher than that of group C at the same time (P < 0.05). The expression of ADM mRNA in renal tissue of group C was not significantly increased within 12 hours after modeling (P < 0.05), but it increased slowly with the prolongation of time, and reached the highest value at 24 hours after modeling. The expression of ADM protein in liver tissue of group C was higher than that of group C at the same time (P < 0.01). The expression of ADM protein in liver tissue of group). A was the highest at 3 h and 12 h after the establishment of the model, and it was the highest at 24 h. The expression of ADM protein in renal tissue of group C was significantly higher than that of group C (P < 0.05) at 24 h (P < 0.05), and reached the peak at 6 h after the establishment of the model (P < 0.05). The expression of ADM protein in renal tissue of group C was higher than that of group C at the same time point (P < 0.05). Conclusion the increase of serum ADM level in ANP rats may be related to the severity of the disease. The increased expression of ADM in the liver and kidney tissues of ANP rats may be related to the severity of liver and kidney injury associated with ANP.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R657.51

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