内脏交感神经对急性坏死性胰腺炎病理生理学变化的影响

发布时间：2018-06-05 21:26

本文选题：急性坏死性胰腺炎 + 内脏大神经　；参考：《河南科技大学》2013年硕士论文

【摘要】：目的：探讨切断内脏交感神经对早期犬急性坏死性胰腺炎（ANP）病理生理学的影响及探索治疗ANP新思路。方法：取20只健康杂种犬随机分为假手术组（n=4）；ANP模型组8只（模型组，n=8）；ANP模型+切断双侧内脏大神经组（实验组，n=8）。动态监测各组外周血清的血淀粉酶、超敏C-反应蛋白、血清钙、肿瘤坏死因子-α、白介素-10的改变。7天后处死全部动物并做病理观察。结果：1.血淀粉酶：假手术组显著低于模型组、实验组，差异有统计学意义（P＜0.01）；模型组与实验组比较，差异无统计学意义（P＞0.05）。2.超敏C-反应蛋白：三组血清超敏C-反应蛋白水平模型复制成功后均升高，术后1天达到峰值，，假手术组升高水平较低，达到峰值后下降快；模型组升高水平最高，达到峰值后下降最慢；实验组升高水平高，达到峰值后下降慢。假手术组与模型组、实验组比较，差异有统计学意义（P＜0.01）；模型组与实验组比较，差异有统计学意义（P＜0.05）。3.血钙水平：三组血钙水平模型复制成功后均降低，假手术组血清钙水平复制成功后降低不明显，基本在正常范围内；模型组血清钙水平复制成功后显著降低，有明显的低血钙症状；实验组血清钙水平复制成功后降低，有低血钙症状。假手术组与模型、实验组比较，差异有统计学意义（P＜0.01）；模型组与实验组比较，差异有统计学意义（P＜0.05）。4.肿瘤坏死因子-α：三组血清肿瘤坏死因子-α水平模型复制成功后升高，术后1天高到到峰值，假手术组升高水平较低，达到峰值后下降快；模型组升高水平最高，达到峰值后下降速度最慢；实验组升高水平中等，达到峰值后下降速度较慢。假手术组与模型、实验组比较，差异有统计学意义（P＜0.01）；模型组与实验组比较，差异有统计学意义（P＜0.05）。5.白介素-10：三组血清白介素-10模型复制成功后均升高，术后1天升高到到峰值，假手术组升高水平较低，达到峰值后下降快；模型组升高水平高，达到峰值后下降慢；实验组升高水平最高，达到峰值后下降速度最慢。假手术组与模型、实验组比较，差异有统计学意义（P＜0.01）；型组与实验组比较差异有统计学意义（P＜0.05）。6.病理评分：B、C组较A组高，B组较C组高，差异有统计学意义（p＜0.05）。结论：1.切断内脏交感神经能改善ANP犬早期严重的应激反应及过度的炎症反应状态。2.切断内脏交感神经能延缓ANP犬早期病理生理学变化进程，且能减轻ANP犬的胰腺病理损伤。
[Abstract]:Objective: to investigate the effect of transection of visceral sympathetic nerve on the pathophysiology of early acute necrotizing pancreatitis (ANP) in dogs and to explore a new idea for the treatment of ANP. Methods: twenty healthy mongrel dogs were randomly divided into sham operation group (n = 8) and model group (n = 8). The changes of serum amylase, hypersensitive C-reactive protein, serum calcium, tumor necrosis factor- 伪 and interleukin-10 in peripheral blood of each group were dynamically monitored. The result is 1: 1. Serum amylase level in sham-operated group was significantly lower than that in model group (P < 0.01), but there was no significant difference between model group and experimental group (P > 0.05). Hypersensitive C- reactive protein: the serum hypersensitive C- reactive protein level of the three groups increased after replicating successfully, reached the peak on the first day after operation, and decreased quickly after reaching the peak in the sham-operation group, and the elevation level in the model group was the highest. In the experimental group, the rising level was high, and the decrease was slow after reaching the peak value. There was significant difference between the sham operation group and the model group (P < 0.01), and the difference between the model group and the experimental group was statistically significant (P < 0.05) and the difference between the model group and the experimental group was significant (P < 0.05). Serum calcium level: the serum calcium level of the three groups decreased after the successful replication, but the serum calcium level of the sham operation group was not significantly decreased after the successful replication, basically within the normal range, the serum calcium level of the model group decreased significantly after the successful replication, and the serum calcium level of the model group decreased significantly after the successful replication of the model group. There were obvious hypocalcemia symptoms, and the serum calcium levels in the experimental group decreased after successful replication, and there were hypocalcemia symptoms. There was significant difference between the sham operation group and the model group (P < 0.01), and the difference between the model group and the experimental group was statistically significant (P < 0.05). Tumor necrosis factor- 伪: the serum tumor necrosis factor- 伪 level in the three groups increased after replicating successfully, reached the peak on the 1st day after operation, and decreased rapidly in the sham operation group, the highest level in the model group, and the highest in the model group. The descending speed was the slowest after the peak value, while the rising level was moderate in the experimental group, and the decreasing rate was slower after the peak value. There was significant difference between the sham operation group and the model group (P < 0.01), and the difference between the model group and the experimental group was statistically significant (P < 0.05). Interleukin-10: the serum interleukin-10 (IL-10) level in the three groups increased to its peak one day after replication and reached the peak level in the sham-operation group, and decreased quickly after the peak in the sham-operation group, the elevation level in the model group was higher than that in the control group, and the decrease was slow after reaching the peak value. The experimental group had the highest level of elevation and the slowest descent rate after reaching the peak value. There was significant difference between the sham operation group and the model group (P < 0.01), and between the type group and the experimental group (P < 0.05). The pathological score of group C was higher than that of group A and group B was higher than that of group C, and the difference was statistically significant (P < 0.05). Conclusion 1. Transection of splanchnic sympathetic nerve can improve early severe stress response and excessive inflammatory response in ANP dogs. Transection of visceral sympathetic nerve could delay the pathophysiological changes in ANP dogs and alleviate the pancreatic pathological injury in ANP dogs.
【学位授予单位】：河南科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R657.51

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