摘要
目的探讨重症急性胰腺炎（SAP）合并急性肺损伤（Au）时肺组织肺表面活性蛋白A（SP-A）的表达及功能改变。方法将20只SD大鼠随机分为假手术（Sham）组（n=10）、SAP组（n=10）。Sham组仅行剖腹术，翻动胰腺。SAP组用去氧胆酸钠经胰胆管逆行注射建立SAP肺损伤模型。各组动物于术后24h取血测动脉血氧分压（PaO2）、血清淀粉酶。处死动物后取肺组织计算肺湿／干重（W／D）比值；应用逆转录-聚合酶链反应（RT—PCR）和免疫组化法测定肺组织SP—A的mRNA及蛋白表达，并观察胰腺、肺组织病理变化及肺泡Ⅱ型上皮细胞的电镜下变化。结果与Sham组比较，SAP组PaOz显著降低[（96．78±3．81）mmHg比（79．24±5．84）mmHg，1mmHg=0．133kPa，P〈0．05]；血淀粉酶显著升高[（1193．41±192．54）U／L比（7144．19±727．91）U／L，P〈0．05]；肺W／D比值显著升高（3．70±0．90比8．57±2．45，P〈0．05）；SP—A的mRNA及蛋白表达显著降低（mRNA：1．21±0．10比0．80±0．11；蛋白：7982．22±3689．57比3497．99土2958．21，P均〈0．05），且SAP组SP—A的mRNA及蛋白表达与肺损伤的程度均呈明显负相关（r1=-0．876，P〈0．01;r2=-0．713，P〈0．05）。结论SAP时肺泡Ⅱ型上皮细胞功能受损、SP—A表达降低可能是Au的发病机制之一。
Objective To investigate the expression and function of surfactant protein A （SP-A） in lung in rats with acute lung injury （ALl） induced by severe acute pancreatitis （SAP）. Methods Twenty Sprague-Dawley （SD） rats were randomly divided into 2 groups： sham operation group （sham, n= 10） and SAP model group （SAP, n= 10）. SAP model was reproduced in SAP group. In sham group daparotomy only was done. Serum amylase （AMY） levels, partial pressure of oxygen in artery （PaO2） and lung wet/dry （W/D） ratio were determined. SP-A mRNA expression in lung was detected by reverse transcriptionpolymerase chain reaction （RT-PCR）. SP-A protein expression in lung tissues was assessed by immunohistochemistry. The pathologic changes in pancreas and lung were observed 24 hours after reproduction of the model. Results Compared with sham group, PaO2 in SAP group was decreased significantly [（96.78± 3.81 ） mm Hg vs. （79.24±5.84） mm Hg, 1 mm Hg=0. 133 kPa, P〈0. 053. Serum levels of AMY and W/D ratio in SAP group were remarkably higher than that in sham group （（1 193.41±192.54） U/L vs. （7 144.19±727.91）U/L, 3.70±0.90 vs. 8.57±2.45, both P〈0.053. The expression of SP-A mRNA in lung tissues in SAP group was significantly down-regulated compared with that in sham group （1.21-＋-0.10 vs. 0. 80±0.11, P 〈 0.05）. The expression of SP-A protein in lung in SAP group was significantly decreased than that in sham group （7 982.22±3 689.57 vs. 3 497.99±2 958.21, P〈0.05）. The pathologic changes in pancreas and lung were marked in SAP group. The expression of SP-A protein and mRNA showed significant negative correlation with the extent of lung injury （r1 =- 0. 876, P〈0.01; r2=-0. 713, P 〈 0. 05）. Conclusion SP-A decreases remarkably in ALl induced by SAP. Type Ⅰ penumonocytes might play an important role in ALl induced by SAP.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2008年第7期390-392,F0003,共4页
Chinese Critical Care Medicine
基金
国家自然科学基金资助项目（90709005）
