Effects Of Yiyanheji On Intestinal Mucosal Cell Apoptosis And Impairment Of Intestinal Mucosa Barrier In Rats Of Severe Acute Pancreatitis

Objective To investigate the changes of the intestinal dysfunction and intestinal mucosal cell apoptosis in rats with severe acute pancreatitis(SAP) and the protecting mechanics about intestinal mucosa by YiyanhejiMethods Seventy-two Wistar rats were randomly divided into 3 groups:sham operation group(SO,n=24),SAP group(n=24) and treated group with Yiyanheji (SAP+YH,n=24).SAP models were induced by injection of 5%sodium taurocholate solution into bilo-pancreatic duct.The treated group was continuously given with amino acid solution by a mini-pump via a central intravenous line,in addition,the treated group was fed Yiyanheji after SAP model induced (1ml/100mg).The changes of terminal ileum tissue were observed by optical microscopy and electron microscopy at 12,24,48h after operation.The expression of Aapf-1 and Bcl-2 in intestinal mucosa of rats were observed with immunohistochemical method.Apoptosis of intestinal mucosa cell was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL).Endotoxin level of portal vein was determined,and pathologic changes of intestinal mucosa were also studied.Bacterial cultures from pancreas, mesenteric lymph node,liver and ascites were done at 12,24,48 h after operation.Results Apoptotic index of intestinal mucosa was increased significantly in SAP group compared to the SO group(P＜0.01),and add up to highest at 12h;The apoptotic index was decreased in Yiyanheji treated rats and no significantly difference compared to that in SO group(P＞0.01).The expression of Aapf-1 in intestinal mucosa of rats was increased significantly in SAP group compared to the SO group(P＜0.01),and add up to highest at 12h;The expression of Bcl-2 was decreased significantly in SAP group compared to the SO group(P＜0.01),and add up to lowest at 12h.The bacterial culture was not found in SO group;The positive rate of bacterial culture was increased significantly in SAP group compared to the SO group(P＜0.01),the positive rate was decreased in SAP+YH group compared to the SAP group(P＜0.01).The level of endotoxin was increased significantly in SAP group compared to SO group(P＜0.01),and decreased in SAP+YH group compared to the SAP group(P＜0.01).Conclusion The intestinal mucosa barrier function was impaired in SAP early, and the impairment of intestinal mucosa barrier was the important pathogenesis of intestinal bacterial and endotoxin translocation.Yiyanheji can inhibit intestinal mucosal apoptosis,protect intestinal mucosa barrier and decrease the intestinal bacterial and endotoxin translocation.