摘要目的 研究Toll受体4(toll receptor-4,TLR-4)在急性胰腺炎(AP)合并中枢神经系统(CNS)损伤中的作用.方法 将64只SD大鼠分为8组:对照组;急性水肿性胰腺炎(AEP)2、6 h组;急性坏死性胰腺炎(ANP)2、6、12、24、48 h组,每组8只.测定血-脑脊液屏障(BBB)通透性、胰腺病理损伤程度、组织TLR-4的表达,并分析其相互关系.结果 对照组,AEP2、6 h组,ANP 2、6、12、24、48 h组的BBB通透性分别为1.55±0.29、1.64±0.17、1.69±0.24、1.89±0.12、2.66±0.32、2.91.4±0.29、2.89±0.69和1.84±0.07;胰腺病理分值分别为0、2.38±0.92、3.13±0.64、8.50±1.07、9.75±0.71、10.25±1.28、1 1.13±1.25和10.13±1.13.AEP组与对照组无显著筹异,ANP各组较AEP组显著升高(P＜0.05或P＜0.01).BBB通透性与胰腺损伤呈正相关(r=0.626,P＜0.01).对照组和AEP组无TLR-4mRNA和蛋白表达,而ANP各组明显表达,其表达水平与BBB通透性水平呈正相关(r=0.208,P=0.027).结论 ANP时存在BBB通透性的升高,CNS内TLR-4信号途径的激活可能参与了ANP所引起的血-脑脊液屏障通透性的升高.

abstractsObjective To investigate the relation between the expression of toll receptor-4 (TLR-4) and the increase of blood brain barrier (BBB) permeability in the rats with acute pancreatitis.Methods Male Sprague-Dawley rats were randomly divided into 8 groups:control group;acute edematous pancreatitis (AEP) 2 h,6 h groups;acute necrotizing pancreatitis (ANP) 2 h,6 h,12 h,24 h,48 h groups with 8 rats in each group.The BBB permeability,pathological score of pancreas,TLR-4 expression were determined and the relationships between them were analyzed.Results The BBB permeability in control group;acute edematous pancreatitis (AEP) 2 h,6 h groups;ANP 2 h,6 h,12 h,24 h,48 h groups were 1.55±0.29,1.64±0.17,1.69±0.24,1.89±0.12,2.66±0.32,2.91±0.29,2.89±0.69 and 1.84±0.07,respectively;the pathological scores of pancreas were 0,2.38±0.92,3.13±0.64,8.50±1.07,9.75±0.71,10.25±1.28,11.13±1.25 and 10.13±1.13,respectively;there was no significant difference between AEP groups and control group,while there was significant difference between AEP groups and ANP groups (P＜0.05 orP ＜0.01).BBB permeability was correlated with pancreatic injury ( r = 0.626,P ＜0.01).There was no TLR-4 mRNA and protein expression in the control and AEP group,while they were significantly expressed in ANP groups,and the expression were positively related with BBB permeability ( r =0.208,P = 0.027 ).Conclusions BBB permeability was present in the course of ANP.Activation of TLR-4 signal pathway may be involved in the BBB permeability increase caused by ANP.