目的探讨血清胰蛋白酶原激活肽(trypsinogen activation peptide, TAP)和C-反应蛋白(C-reactive protein, CRP)在大鼠急性胰腺炎(acute pancreatitis,AP)发生、发展中的作用。方法将96只SPF级健康雄性Wistar大鼠随机分为假手术组和AP组,每组48只。假手术组仅打开腹腔翻动胰腺数次后关腹,AP组建立急性胰腺炎动物模型,两组在造模后3、6、12、24 h四个时点分批处死。每只大鼠处死前腹主动脉采血5 ml,取胰腺组织进行HE染色并做病理评分。应用ELISA法定量检测各组大鼠血清TAP和CRP的含量。结果(1)AP组胰腺组织病理评分随造模时间延长明显增高,差异有统计学意义(P<0.05)。(2)假手术组与AP组造模后同时点比较,TAP水平差异均有统计学意义(P<0.05),假手术组各时点间比较,TAP水平均无统计学差异(P>0.05),AP组造模后3 h(1.41±0.19)、6 h(2.09±0.33)、12 h(3.16±0.23)、24 h(4.53±0.28)四个时点比较,TAP水平均有统计学差异(P<0.05)。(3)AP组造模后各时点间比较,CRP水平均有统计学差异(P<0.05)。(4)血清TAP(r=0.942)、CRP(r=0.926)含量均与胰腺组织病理评分呈高度正相关(r>0.7,P<0.05)。结论血清TAP可作为早期诊断急性胰腺炎的可靠指标;对TAP和CRP动态检测可判断AP的严重程度。

Objective To study the role of serum TAP and CRP in occurrence and development of acute pancreatitis(AP) in rats. It can provide a theory basis for early diagnosis of AP. Methods 96 specific pathogen free(SPF) Wistar male rats were divided into two groups randomly (n=48 in each group): sham-operated group and AP model group. In sham-operated group,we only opened the abdominal cavity and touched pancreas several times.In AP model group, 5% Na-Tc was injected under the membrane of pancreas to establish AP animal model. The rats were killed at 3 rd, 6 th, 12 th and 24 th hour after modeling in each group. A portion of pancreatic tissues was examined by hematoxylin-eosin(HE) staining. We detected the concentration of TAP and CRP in serum by enzyme-linked immunosorbent assay(ELISA) . Results The concentration of TAP in sham-operated group, compared with AP group at the same time, was significantly different (P＜0.05). The concentration of TAP in AP group had significant differences (P＜0.05) compared with each other. The concentration of CRP in sham-operated group at 6th, 12th, 24th hour compared with AP group at the same time was significantly different (P＜0.05). The concentration of CRP in AP group had significant differences (P＜0.05) compared with each other. The concentration of TAP and CRP showed higher positive correlation with the pancreatic histopathologic scores. Conclusions Serum TAP can be used for diagnosis of AP in early stage for judgment. TAP and CRP detected dynamically in AP in early stage can be used as indicators of serverity, which plays an important role in forecasting AP.