探讨急性重症胰腺炎（SAP）大鼠肠黏膜屏障功能障碍的发生机制。

按随机数字表法将48只SD大鼠随机分为SAP模型组（SAP组）和假手术组（SO组），每组24只。SAP组采用3%牛磺胆酸钠胰管逆行注射建立SAP模型，SO组开腹后仅翻动肠管。术后6、12、24 h时间点，每组大鼠分别取8只开腹后测量腹腔积液量，抽取下腔静脉血检测血淀粉酶、肿瘤坏死因子（TNF）-α、D-乳酸、二胺氧化酶(DAO)水平，处死后取胰腺和回肠末端组织行病理学检查。两组间实验数据比较采用t检验。

SAP组模型建立成功，建模大鼠出现腹腔积液、血淀粉酶升高、胰腺组织病理学损伤。术后6、12、24 h，SAP组血TNF-α平均水平分别为（262±17）、(320±18)、（382±33）μg/L，明显高于SO组的（201±16）μg/L（t= 10.066，7.387，7.720；P<0.05）。SAP组肠黏膜通透性升高和肠道菌群失调，血D-乳酸相应为（168±14）、（200±15）、（255±24）μg/L，明显高于SO组的（125±9）μg/L（t=13.211，25.191，36.888；P<0.05）。SAP组血DAO相应为（156±12）、（196±11）、（220±14）μg/L，明显高于SO组的（119±6）μg/L（t=23.811，43.561，48.069；P<0.05）；SAP组回肠黏膜组织损伤，出现局部灶性或片状肠坏死，SO组回肠黏膜组织结构完整。

TNF-α激活、肠道菌群失调和肠道通透性升高可能在大鼠SAP肠黏膜屏障功能障碍中起重要作用。

To investigate the mechanism of intestinal barrier functional disturbance in rats with severe acute pancreatitis (SAP).

Forty-eight Sprague-Dawley (SD) rats were randomly divided into SAP model group (SAP group, n=24) and sham operation group (SO group, n=24) according to the random number table method. SAP model was established in SAP group by retrograde injection of 3% sodium taurocholate in pancreatic duct. The intestinal canals of rats in SO group were only flipped after laparotomy. At the time points of 6, 12, 24 h after operation, the seroperitoneum volume of 8 rats in each group was measured after laparotomy and the inferior vena cava blood was collected to measure the levels of blood amylase, tumor necrosis factor (TNF)- α, D-lactic acid, diamine oxidase (DAO) . The tissues of pancreas and terminal ileum were pathologically examined after the rats were sacrificed. The experimental data of two groups were compared using t test.

SAP model was established successfully in SAP group and seroperitoneum, increasing blood amylase, pathological damage of pancreatic tissues were observed in the rats. At the time points of 6, 12 and 24 h after operation, the average blood TNF- α levels in SAP group [(262±17), (320±18), (382±33) μg/L] were significantly higher than that in SO group [(201±16) μg/L] (t=10.066, 7.387, 7.720; P<0.05). Increasing intestinal permeability and alteration of intestinal flora were observed in SAP group. The blood D-lactic acid levels were (168±14), (200±15), (255±24) μg/L accordingly in SAP group and were significantly higher than that in SO group [(125±9) μg/L] (t=13.211, 25.191, 36.888; P<0.05). The blood DAO levels were (156±12), (196±11), (220±14) μg/L accordingly in SAP group and were significantly higher than that in SO group [(119±6) μg/L] (t=23.811, 43.561, 48.069; P<0.05). The ileum mucosa damage and local focal necrosis or piecemeal intestinal necrosis were observed in SAP group. The intact structure of ileum mucosa tissues were observed in SO group.

The activated TNF- α, alteration of intestinal flora and increasing intestinal permeability may play important roles in the intestinal barrier functional disturbance of rats with SAP.