重症急性胰腺炎继发感染早期肝损伤时髓样细胞表达激发受体-1的诊断价值

目的 探讨髓样细胞表达激发受体-1(TREM-1)在重症急性胰腺炎继发感染(SISAP)早期肝损伤中的诊断价值和作用机制.方法 24只雄性SD大鼠随机分为对照组、重症急性胰腺炎组(SAP组)、SISAP组.通过腹腔注射L-精氨酸、大肠杆菌构建动物模型,造模后24 h测定血淀粉酶活性、谷氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肿瘤坏死因子(TNF)-α、C反应蛋白(CRP)及TREM-1表达变化;取血清和腹水进行细菌培养,取部分胰腺及肝组织光学显微镜下进行组织病理学评分;实时聚合酶链反应(RT-PCR)和western 印迹检测肝组织中TREM-1 mRNA和蛋白的表达.结果 SAP组和SISAP组胰腺及肝脏病理评分、血清淀粉酶活性、ALT和AST均明显高于对照组(P<0.05),且SISAP组较SAP组增高(P<0.05).SAP组和SISAP组的CRP、TNF-α均明显高于对照组(P<0,05),但两组间差异无统计学意义(P值分别=0.262和0.359).血清和腹水细菌培养阳性率,对照组为0/8,SAP组为1/8,SISAP组为8/8.SAP组肝脏组织TREM-1 mRNA的表达量为2.10±0.33,SISAP组为4.58±1.00,均明显高于对照组(1.00,P<0.05),且SISAP组较SAP组增高(P<0.05).SISAP组TREM-1蛋白处于较高表达水平,表达明显强于对照组和SAP组.结论 TREM-1可能在SISAP引起的早期肝损伤中具有重要作用.

Abstract：

Objective To explore the diagnosis value and the mechanism of triggering receptor expressed on myeloid cells-1 (TREM-1) in early liver damage of severe acute pancreatitis with secondary infection. Methods Twenty-four male SD rats were randomly divided into the control group, the severe acute pancreatitis (SAP) group and the secondary infection of SAP (SISAP) group.The animal model was established by intraperitoneal injection of L- arginine and E. coli. After 24 hours, the serum levels of amylase, glutamate aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and the variation of TREM-1 expression were tested. The blood and peritoneal fluid samples were collected for bacterial culture.Part of the pancreas and liver tissue were taken for histopathological score under microscope. The expression of TREM-1 at mRNA and protein level in liver tissue was detected through Real-time PCR and Western Blot. Results The histological score of pancreas and liver, serum amylase, ALT and AST were significantly higher in the SAP and SISAP groups than those in C group (P<0. 05), and higher in SISAP group than in SAP group (P<0. 05). The CRP and TNF-a expression in SAP and SISAP groups were higher then those in control group, while there was no significant difference between the two groups (P=0. 262 and 0. 359 , respectively). The positive ratio of bacterial culture in blood and peritoneal fluid was 0(0/8), 12. 5% (1/8), and 100% (8/8) in control group, SAP group and SISAP group respectively. The expression of TREM-lmRNA in liver was 2. 10 ± 0. 33 in SAP group and 4. 58+ 1. 00 in SISAP group, which were significantly higher than that in control group (1. 00,P<0. 05) , and the expression of TREM-1 mRNA in SISAP group was higher than that in SAP group (P < 0.05). The expression of TREM-1 at protein level was higher in SISAP group,significantly stronger than that in control and SAP group. Conclusions TREM-1 may play an important role in the early liver damage caused by severe acute pancreatitis.

The diagnosis value of triggering receptor expressed on myeloid cells-1 in early liver damage of severe acute pancreatitis with secondary infection

Objective To explore the diagnosis value and the mechanism of triggering receptor expressed on myeloid cells-1 (TREM-1) in early liver damage of severe acute pancreatitis with secondary infection. Methods Twenty-four male SD rats were randomly divided into the control group, the severe acute pancreatitis (SAP) group and the secondary infection of SAP (SISAP) group.The animal model was established by intraperitoneal injection of L- arginine and E. coli. After 24 hours, the serum levels of amylase, glutamate aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and the variation of TREM-1 expression were tested. The blood and peritoneal fluid samples were collected for bacterial culture.Part of the pancreas and liver tissue were taken for histopathological score under microscope. The expression of TREM-1 at mRNA and protein level in liver tissue was detected through Real-time PCR and Western Blot. Results The histological score of pancreas and liver, serum amylase, ALT and AST were significantly higher in the SAP and SISAP groups than those in C group (P<0. 05), and higher in SISAP group than in SAP group (P<0. 05). The CRP and TNF-a expression in SAP and SISAP groups were higher then those in control group, while there was no significant difference between the two groups (P=0. 262 and 0. 359 , respectively). The positive ratio of bacterial culture in blood and peritoneal fluid was 0(0/8), 12. 5% (1/8), and 100% (8/8) in control group, SAP group and SISAP group respectively. The expression of TREM-lmRNA in liver was 2. 10 ± 0. 33 in SAP group and 4. 58+ 1. 00 in SISAP group, which were significantly higher than that in control group (1. 00,P<0. 05) , and the expression of TREM-1 mRNA in SISAP group was higher than that in SAP group (P < 0.05). The expression of TREM-1 at protein level was higher in SISAP group,significantly stronger than that in control and SAP group. Conclusions TREM-1 may play an important role in the early liver damage caused by severe acute pancreatitis.