| Background and objectives:AP is a common critical acute abdominal disease in the clinical work and in recent years the incidence is on the rise, mainly for the pancreatic edema、hemorrhage or necrosis and presented with acute process. Generally after fasting、inhibit pancreatic secretion、rehydration、anti-infection treatment, patients usually characterized by MAP, prognosis is good. About 20% of the patients will develop further in clinical, even after a formal medical intervention, thus presented with SAP. Then the condition is dangerous, there will be a variety of complications, such as abdominal infection、pancreatic abscess and so on, even multiple organ failure、 shock will coming, It’s a threaten to patient’s life, and the fatality rate is high. In view of the great differences between MAP and SAP, and the high fatality rate of SAP, so it’s very important for the early diagnosis of SAP. VDBP has close relationship with inflammatory reaction, so we want to observe the change of serum VDBP to offer us new strategy for the early diagnosis and treatment of SAP. At the same time we know that one of the reasons for high mortality is due to MODS, previous studies have confirmed that the main reason for MODS is gastrointestinal dysfunction, if the function of gastrointestinal tract get effective protection will reduce the incidence of MODS and to reduce the mortality of SAP, improve the clinical curative effect, taurine can improve its function at the cellular level, so it will play the role of improving the function of the gastrointestinal tract. Therefore this topic selected taurine to study its protective effect on gastrointestinal, looking forward to bring better medical effect for patients with SAP.Methods:1. The SAP model was replicated by retrograde injection of sodium taurocholate into cholangiopancreatic duct. Thirty male Sprague-Dawley rats were randomly divided into three groups:sham-operated group (without sodium taurocholate injection, n=10), SAP group (n=10) and Normal comparison group(n=10). Animals were sacrificed 12 hours after operation. Collection and determination of interior venous blood to measure the serum amylase、VDBP、CRP、TNF-a; separate the rat pancreas carefully, removed completely and weighted, calculate the pancreas weight/body weight ratio, sections stained with HE and observed under light microscopy, structure damaged seriously, at the same time appeared a large number of inflammatory cells.2. Use the same SAP model making method, Thirty male Sprague-Dawley rats were randomly divided into three groups:sham-operated group (without sodium taurocholate injection, n=10), SAP group(n=10) and Taurine treatment group(n=10). Animals were sacrificed 24 hours after operation. Collection and determination of portal venous blood endotoxin level before death, interior venous blood to measure the serum amylase, take the terminal ileum 6 cm measurement terminal ileum mucosa malonaldehyde (MDA) and calcium content after death, then observe the villus height and mucosal thickness changes.Results:1. the serum amylase、CRP and TNF-α level is significantly increased in SAP group than normal comparison group and sham-operated group(P<0.05), the VDBP is decline sharply in SAP group compared with normal comparison group and sham-operated group(P<0.05). The VDBP level compared to CRP、TNF-α level and pancreatic tissue pathologic grading demonstrated a negative correlation(r=-0.731,-0.743,-0.789, P<0.05). The rat pancreas appeared necrosis when observed with light microscope,2. the endotoxin level is significantly increased in SAP group than sham-operated group(P<0.05) and is decline sharply in taurine treatment group(P<0.05); The serum amylase is significantly increased in SAP group compared with sham-operated group and taurine treatment group; the ileum mucosa malonaldehyde (MDA) and calcium content is significantly increased in SAP group; The rats’ileum normal form in sham-operated group when observed with light microscope, villi structural integrity and columnar epithelium, striated border, no interstitial edema, and no inflammatory cells infiltration, however villi epithelium is significantly shorter in SAP group, partial necrosis falls off and a large number of inflammatory cell infiltration, villi is slightly shorter in taurine treatment group, with a mild edema and inflammatory cells infiltration.Conclusions:1. VDBP may be associated with the occurrence and development of SAP and can be used one of the effective index to predict the severity of acute pancreatitis.2. Taurine has a protective effect to the rat intestinal mucosal barrier function in severe acute pancreatitis. |
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