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[目的]研究重症急性胰腺炎(SAP)心肌功能损害时心肌核转录因子κB(NF-κB)的活化及葡激酶的干预作用。[方法]63只SD大鼠随机分为假手术组(n=9)、对照组(n=27)、葡激酶合用益活清胰汤治疗组(n=27),SAP模型采用5%牛磺胆酸钠胰胆管逆行注射方法建立。ELISA法测定6、12、24 h各时点血肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平,RT-PCR检测心肌NF-κB mRNA的表达,免疫组化法检测心肌NF-κB蛋白的表达,苏木精-伊红染色光镜下观察胰腺及心肌组织的病理变化。[结果]术后6 h大鼠心肌NF-κB mRNA及其蛋白表达异常增高,TNF-α、IL-6呈进行性升高,治疗组用药后心肌NF-κB mRNA及蛋白表达下调,血TNF-α、IL-6明显下降,与对照组相比P<0.05,治疗组胰腺及心肌组织的病理变化减轻。[结论]SAP大鼠心肌损伤可能与循环中TNF-α、IL-6水平升高导致的心肌NF-κB活化有关,益活清胰汤合用葡激酶对SAP并发的心肌损伤具有防治作用。
[Objective] To investigate the activation of nuclear factor kappa B (NF-κB) and the effect of staphylokinase in myocardial injury of severe acute pancreatitis (SAP). [Methods] Sixty-three Sprague-Dawley rats were randomly divided into sham operation group (n = 9), control group (n = 27) and staphylokinase combined with Yifeng Qingyiyutang treatment group (n = 27) Sodium hypochlorite and pancreaticobiliary duct retrograde injection method was established. The levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) at 6, 12 and 24 h were measured by ELISA. The expression of NF-κB mRNA was detected by RT- The expression of NF-κB in myocardium was detected. The pathological changes of pancreas and myocardium were observed under hematoxylin-eosin staining. [Result] The expression of NF-κB mRNA and protein in the myocardium of rats increased abnormally at 6 h after operation, and the levels of TNF-α and IL-6 increased progressively. After treatment, the expression of NF-κB mRNA and protein in the myocardium was decreased, -α and IL-6 significantly decreased, compared with the control group P <0.05, the treatment group, the pathological changes of the pancreas and myocardial tissue reduced. [Conclusion] Myocardial injury in SAP rats may be related to the activation of NF-κB induced by elevated levels of TNF-α and IL-6 in circulation, and that Yi-Yi Qing-Yi Decoction combined with staphylokinase can prevent and treat myocardial injury complicated by SAP.