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目的:探讨同种异体骨髓间充质干细胞(BMSCs)对ANP大鼠炎症反应及腹腔巨噬细胞极化状态的影响。方法:将30只Sprague Dawley雄性大鼠分为对照组，ANP组，低(0.5×10n 6个细胞)、中(1×10n 6个细胞)、高剂量(2×10n 6个细胞)BMSCs治疗组。采用胰胆管逆行注入5%牛黄胆酸钠1 ml/kg的方法制备ANP模型。BMSCs在制膜后1 h内经大鼠尾静脉注入。取大鼠胰腺组织行病理检查，免疫组织化学法检测诱导型一氧化氮合酶(iNOS)、精氨酸酶1(Arg1)蛋白表达阳性的巨噬细胞。取外周血检测淀粉酶、TNF-α、IL-1β和髓过氧化物酶(MPO)水平。通过腹腔灌洗从灌洗液中获取巨噬细胞，应用实时荧光定量PCR法检测巨噬细胞TNF-α、iNOS mRNA表达，流式细胞技术检测M1(F4/80n ＋CCR2n ＋)型和M2(F4/80n ＋CDn 163＋)型巨噬细胞表达的动态变化。n 结果:各治疗组大鼠胰腺组织病理损伤较ANP组明显减轻。ANP组大鼠胰腺组织内出现较多的iNOS、Arg1阳性巨噬细胞，而对照组及各治疗组无或仅有少量阳性细胞。3个治疗组中，中剂量BMSCs治疗组的治疗效果显著高于其他2组，差异有统计学意义(n P值均<0.05)。与ANP组大鼠比较，除血淀粉酶外，中剂量治疗组血TNF-α[(99.5±11.8)ng/L比(185.5±27.5)ng/L]、IL-1β[(24.1±3.7)ng/L比(128.5±66.1)ng/L]、MPO[(643.8±98.4)ng/L比(2131.9±261.4)ng/L]水平，腹腔巨噬细胞TNF-α(2.16±0.98比6.53±3.45)、iNOS(2.32±1.88比7.37±2.98)mRNA表达量，巨噬细胞M1型与M2型比值(1.53±0.10比2.02±0.31)均显著下降，差异均有统计学意义(n P值均<0.05)。ANP组和3个治疗组的上述所有指标均显著高于对照组，差异有统计学意义(n P值均<0.05)。n 结论:静脉注射同种异体BMSCs可抑制腹腔巨噬细胞向M1型极化，降低腹腔巨噬细胞M1型与M2型比值，减轻ANP大鼠的炎症反应。“,”Objective:To study the effects of bone marrow mesenchymal stem cells (BMSCs) on the inflammatory response and polarization of peritoneal macrophages in rats with acute necrotizing pancreatitis (ANP).Methods:Thirty Sprague Dawley male rats were divided into control group, ANP group, low-dose (0.5×10n 6 cells), medium-dose(1×10n 6 cells)and high-dose (2×10n 6 cells)BMSCs treatment groups. ANP model was established n via the retrograde injection of 1ml/kg 5% sodium taurocholate hydrate into pancreaticobiliary duct. BMSCs were injected n via caudal vein 1 h after molding. Tissues of the rat pancreas were taken for pathological examination, and iNOS and ARG1 positive macrophages were detected by immunohistochemistry. The level of amylase, TNF-α, IL-1β and MPO were measured in peripheral blood. Abdominal macrophages were obtained by intraperitoneal perfusion, and TNF-α and iNOS mRNA expression of macrophages were detected by real-time fluorescence quantitative PCR; and the dynamic changes of M1(F4/80n + , CCR2n + ) and M2 (F4/80n + , CDn 163+ ) macrophages were detected by flow cytometry.n Results:The pathological injury of pancreatic tissue in the three treatment groups was obviously less serious than that of ANP group. In ANP group, more iNOS and ARG1 positive macrophages were present in rat pancreatic tissue, while none or only few iNOS and ARG1 positive macrophages were observed in control group and treatment group. The therapeutic effects of medium dose (1×10n 6)BMSCs treatment group was significantly better than those of the other two treatment groups, with statistically significant differences(all n P<0.05). Compared with ANP group, TNF-α[ (99.5±11.8)ng/Ln vs (185.5±27.5)ng/L ], IL-1β[ (24.1±3.7)ng/Ln vs (128.5±66.1)ng/L ], MPO [ (643.8±98.4)ng/L n vs (2131.9±261.4)ng/L ], TNF-α (2.16±0.98n vs 6.53±3.45) and iNOS (2.32±1.88 n vs 7.37±2.98) mRNA expression in peritoneal macrophages, and the ratio of M1/M2 (1.53±0.10 n vs 2.02±0.31)were all greatly decreased, and the differences were all statistically significant (all n P<0.05), except for blood amylase. All the above indexes in ANP group and the three treatment groups were all significantly higher than those in the control group, with statistically significant differences (alln P<0.05).n Conclusions:Intravenous infusion of allogeneic BMSCs can inhibit the M1 type polarization of peritoneal macrophages, reduce the M1/M2 ratio of peritoneal macrophages, and alleviate the inflammatory response in ANP rats.