| Objective:Severe acute pancreatitis (severe acute pancreatitis,SAP) is one of critical disease, easy to cause multiple organ dysfunction(multiple outraged dysfunction syndrome, MODS) and make conditiondeteriorated rapidly. SAP earlyly releases vasoactive peptide (vasoactiveintestinal peptide, VIP) which has strong toxicity substances of renal,At thesame time a large number of trypsin activation but also activation of the renin-angiotensin system, due to the glomerular vessels contraction, resulting inreduced glomerular perfusion pressure, superimposed on a variety of factorsultimately lead to acute renal injury. SAP generated a large amount of ascites,maked less effective circulating blood volume, which cause kidneys to a seriousshortage of blood supply;Abdominal cavity effuse a large number ofinflammatory liquid, containing necrotic tissue, bacteria, toxins, proteinbreakdown products, cell factors, enzymes, etc. which may absorb through theperitoneal into the blood circulation, and are of great toxicity to kidney. Inrecent years, the Chengdu Military General Hospital’s general surgery centertake out peritoneal catheter drainage, mainly a variety of minimally invasivetreatment of SAP, patients achieved good curative effect, avoid surgical traumaand risk of the traditional pancreatic necrosis tissue removal and ascitesdrainage. But concrete mechanism of peritoneal catheter drainage to improve SAP patients is not clear. In this study, by detecting the SAP rat peritonealcatheter drainage at different time points serum amylase (AMY), urea nitrogen(BUN), creatinine (Cr), nuclear factor kappa B (NF-kappa B), ascites amylase(AMY),nuclear factor kappa B (NF-kappa B), the level of detection of kidneytissue expression of NF-kappa B protein, and the observation of the pancreas,kidney tissue pathological changes, to explore effect and possible mechanism ofrenal injury of peritoneal catheter drainage after SAP in rats. Methods:72wistar rats weight200-250g were randomly divided into three groups afterfledging for a week:A group(SAP model group), B group(SAP drainage group),C group(the sham control group).(N=24), each group divided into6,12,24hthree time points, each time points allocation8rats,12hours before theexperiment and after fasting can not help but water.(1) group A: referencemethod of Aho, intraperitoneal injection of3%sodium pentobarbital (0.1ml/100g body weight）anesthesia, laparotomy artery clip occlusion of hilar bileduct, duodenal papilla retrograde cholangiopancreatography puncture withinfusion pump injection of5%sodium taurocholate (0.1ml/100g body weight)the speed of3ml/h, end note3to5min after injection artery clip clippingnearly duodenal end of the pancreatic duct10minutes, Change of macroscopicpancreatic tissue congestion, edema, hemorrhage, necrosis, confirm that the ratswere prepared successfully SAP animal models, the abdomen was closed;(2)group B: after the success of the SAP model preparation, intraperitonealcatheter drainage at the lower abdomen of rats, abdominal drainage tube end connected to a drainage bag.(3)group C: only laparotomy surgery, closedabdomen after turning of the pancreas. All rats were injected37℃physiological saline in the back of rats according to40ml/kg weight, onceevery12hours, a total of two.2.6,12,24h after building model, collectabdominal aortic blood,3000r/min centrifugal10minutes, the supernatant wasplaced at-20℃to prepare for the detection. Collection the ascites drainagegroup drainage bag,3000r/min centrifugal10minutes the supernatant wasplaced at-80℃to prepare for the detection.Kidney tissue was fixed in4%neutral buffered formaldehyde. Pancreas and kidney tissues were frozen inliquid nitrogen, and stored at-80℃refrigerator.Automatic biochemical analyzerdetect serum and ascites amylase, serum urea nitrogen (BUN), creatinine (Cr),ELISA method for the determination of serum and ascites of nuclear factorkappa B (NF-kappa B) level, Immunohistochemical method for thedetermination of NF-kappa B protein expression in kidney tissue,to observe thepathological changes of the pancreas and kidney tissue sections by HEstaining.3. By using the statistical software analysis of SPSS19.0, the data wereexpressed as－x±s, two samples were compared using t test, the multiple werecompared using analysis of variance, P <0.05for the difference was statisticallysignificant. Results:1. The rats of group A after the success of the buildingactivity decreased, depression, loss of appetite, urine volume decreases; Andwith the extension of time, the symptom is aggravating gradually. Group B thangroup A rat activity, spirit,appetite, urine output is better; with the ascites constantly drainage, the symptoms gradually improved. Group C ratspostoperative activities, spirit, appetite, urine volume did not changesignificantly.2. Group A, group B than in group C serum amylase, urea nitrogen(BUN), creatinine (Cr), NF-kappa B significantly increased, ascites amylase,NF-kappa B significantly increased, pancreatic and renal pathologicalchanges,an increase in renal tissue expression of NF-kappa B protein;Group Bcompared with group A serum amylase, urea nitrogen (BUN) and creatinine(Cr), NF-kappa B and ascites amylase, NF-kappa B significantly reduced,changes in the pancreas and kidney disease management relief, reduced renaltissue NF-kappa B protein expression.Conclusion:1. Laparotomy retrogradecholangiopancreatography injection of sodium taurocholate, can be successfullyprepared rat model of SAP.2. By intraperitoneal catheter drainage ratpancreatitis associated ascites (PAAF), can significantly improve thesymptoms.3. Rat peritoneal drainage of pancreatitis associated ascites (PAAF),you can reduce the level of serum amylase (AMY), urea nitrogen (BUN),creatinine (Cr), nuclear factor kappa B (NF-kappa B), reduce the level ofascites amylase (AMY), nuclear factor kappa B (NF-kappa B), reducing kidneytissue expression of NF-kappa B protein,significantly reduced SAP rat pancreasand kidney pathological damage. |
PDF Full Text Request