摘要
目的观察肠缺血时肠粘膜的病理改变及肠道细菌移居的时间特征。方法结扎大鼠回肠末段系膜动脉分支制作肠缺血模型，以缺血后２，６，１２ｈ测定门脉血及心脏血内毒素，取肠系膜淋巴结（ＭＬＮ）、肝、脾、血液作细菌培养，光镜及电镜观察缺血与缺血边缘区肠粘膜变化。结果缺血及缺血边缘区肠粘膜均受损；缺血早期门脉血对潘（３８９．０±１０５．０ｎｇ／Ｌ，ｖｓ５５．１±６．７ｎｇ／Ｌ，ｎ＝２０，ｔ＝１２ｈ，Ｐ＜０．０１）及心脏血内毒素（２４５．０±８８．０ｎｇ／Ｌ，ｖｓ４０．９±６．５ｎｇ／Ｌ，ｎ＝２０，ｔ＝１２ｈ，Ｐ＜０．０１），明显升高；ＭＬＮ、肝、脾、血液内都有肠道细菌存在。结论肠缺血使粘膜屏障受损，造成肠腔内细菌移居及内毒素入血，内毒素加重肠粘膜损害。
AIMS To investigate the changes of intestinal mucosa and time character of bacterial translocation from the gastrointestinal tract(GI) in rats with segmental intestinal ischemia. METHODS The distal ileal mesenteric arteries were ligated to make segememtal intestinal ischemia models. In 2, 6, 12h after intestinal ischemia, endotoxin levels in portal and cardiac blood were determined, bacteria in mesenteric lymph nodes (MLN), liver, spleen, blood and histological changes of the mucosa were examined under light and electron microscope. RESULTS Mucosa were injuried both in ischemia and peri_ischemia area, endotoxin levels elevated in portal(389.0±105.0ng/L, vs 55.1±6.7ng/L, n=20, t=12h, P<0.01) and cardiac blood(245.0±88.0ng/L, vs 40.9±6.5ng/L, n=20, t=12h, P<0.01), and bacteria from GI were found in MLN, liver, spleen and blood. CONCLUSIONS Bacterial translocation from GI exists due to impairement of gut barrier, caused by intestinal ischemia and endotoxin accelerats injuries of mucosa with vicious cycle.
基金
全军"八五"协作攻关课题
关键词
肠缺血
肠道细菌移居
病理
bacterial infections\ \ endotoxins\ \ mesenteric vascular occlasion
