本文旨在探讨内源性硫化氢(hydrogen sulfide,H2S)与慢性应激大鼠结肠高动力的关系。大鼠随机分为慢性避水应激(water avoidance stress,WAS)组和假避水应激(sham water avoidance stress,SWAS)组,记录大鼠每日1 h应激期间大便粒数,连续10 d;分别制作结肠平滑肌条,使用生物机能实验系统记录两组肌条自发性收缩活性以及SWAS组H2S合成酶抑制剂预处理后收缩活性;测定结肠内源性H2S的产生浓度;采用免疫组化和Western blot等方法观察结肠内源性H2S合成酶分布及表达。结果显示,WAS组大鼠应激期间大便粒数、结肠肌条收缩的曲线下面积(area under the curve,AUC)均高于SWAS组(P<0.05);WAS组结肠内源性H2S产生量明显低于SWAS组(P<0.001);H2S合成酶胱硫醚-γ-裂解酶(cystathionine-γ-lyase,CSE)在纵行肌条和环形肌条细胞浆、肌间神经元细胞核中强表达,胱硫醚-β-合成酶(cystathionine-β-synthase,CBS)主要表达于肌间神经元胞浆;与SWAS组相比,WAS组大鼠结肠(去除粘膜及粘膜下层后)CBS和CSE的表达下调(P<0.001);H2S合成酶抑制剂明显增加SWAS组肌条收缩的AUC(P<0.001)。以上结果表明,内源性H2S合成酶表达下调、H2S合成减少是慢性应激结肠高动力的原因之一。
BACKGROUND: Disturbance of gastrointestinal function is a common complication in the early phase of acute pancreatitis (AP). Intestinal gas may reflect the function of the gut. Using plain abdominal radiographs, we investigated whether intestinal gas volume is related to AP. METHODS: Plain abdominal radiographs of 68 patients with AP within 24 hours after admission and 21 normal controls were digitized and transmitted to a computer. The region of intestinal gas was identified by an image manipulation software and the gas volume score (GVS) was calculated. The relationships between the GVS values and various clinical factors of AP were analyzed. RESULTS: The GVS in the AP group was 0.084±0.016, in the mild AP (MAP) group 0.070±0.005, and in the severe AP (SAP) group 0.094±0.013; all values were higher than that in the control group (P<0.01). The GVS in the SAP group was higher than that in the MAP group. The GVSs were correlated to the Ranson’s scores (r=0.762, P<0.01) and the acute physiology and chronic health evaluation II (APACHE II) scores (r=0.801, P<0.01). In addition, the GVS in patients with secondary pancreatic and/or peripancreatic infection was 0.107±0.014, higher than that in patients without secondary infection (P<0.01). GVS was not related to gender, age, etiology or clinical outcome of AP. CONCLUSIONS: Intestinal gas volume is significantly elevated in patients with AP. It is closely related to Ranson’s and APACHE II score and secondary pancreatic and/or peripancreatic infection. GVS may be a new prognostic tool for assessing the severity of AP in the early course of the disease.
Ying Liu and He-Sheng Luo Department of Gastroenterology, Renmin Hospital, Wuhan University, Wuhan 430060, China
