摘要
目的应用肠系膜上动脉阻断模型,探讨肠I/R损伤的作用机制,观察抑肽酶在肠I/R过程中对肠的保护作用,从而为抑肽酶在临床中的应用提供一定的理论依据。方法24只日本大耳白兔随机分为3组(每组8只),A组为假手术组,SMA不作阻断,B组为缺血/再灌注组,C组为抑肽酶治疗组,B、C2组SMA均作阻断。采用家兔肠系膜上动脉阻断(SMAO)模型,阻断时间为45min。C组阻断前5min静注抑肽酶30000KIU/Kg,随后以10000KIU/(Kg·h-1)维持至实验结束。B、C组在阻断前(Io)、阻断45min(I1),再灌注1h(R1)、再灌注2h(R2)各时点观察血清PHi、TNFα、PH和SO2及肠组织形态学变化。A组在相应时点取样检测上述指标。结果(1)C组PHi、SO2、PH在R2时的血清值分别为:(7.193±0.077)、(86.428±6.078)(%)、(7.324±0.166);PHi、SO2、PH明显高于B组相应值:(6.695±0.177)和(70.428±9.306)(%)、(7.027±0.137);C组TNFα在R2时的血清值为:(2.94±0.382)ng/mL、明显低于B组相应值:(4.15±0.495)ng/mL、(P<0.05)。而B组明显高于A组值(P<0.05)。(2)肠道肉眼观察C组肠管呈红色,有蠕动现象,B组肠管呈暗红色,有点状出血灶;光镜观察,C组肠粘膜损伤明显轻于B组(P<0.05);电镜观察,C组小肠绒毛,线粒体、内质网损伤较轻,B组损伤较重。经秩和检验组间有显著性差异(表5)。结论抑肽酶不仅对肠缺血再灌注损伤有一定保护作用,减轻脂质过氧化反应,而且还可以减少TNFα的产生和释放,减轻肠I/R,可以改善肠粘膜PHi和门静脉SO2、PH等作用,因此,抑肽酶能改善肠缺血后低灌注,对肠I/R损伤有较好的保护作用。
Objective Study the effect of the intestinal ischemia reperfusion injury on the intestinal and another organ using SMAO model,To observe the protective effect of aprotinin on the intestinal during the intestinal isehemia reperfusion injury.Methods 24 rabbits were randomly divided into three groups （n=8）：Control group （A）,SMA wasnot obstructed.ischemiafreperfusion group（B） and aprotiin group （C）.SMAO model was prepared and obstructed time was 45min ,and reperfasion for 2h.In the group C ,aprotinin was injected into Vein 5rain before clamping at 30000KIU/Kg,and was kept on at 10000KIU/（Kg·h^-1）, PHi, portal vein blood gas,Tumor mecresis factoralpha （TNFα）of serum were measured before obstruction （I0）,at claming for 45rain （I1）and lh（Rt）,2h（R2）after reperfusion respectively.Thelivet was examined for morphological changes.Results （1）The level of PHi SO2 , PH of serum at R2 in the group C were （7.193 ± 0.077）,（86.428 ±6.078）（%）,（7.324 ±0.166）; were significantly markly higher than those of group B（P〈0.05）.But the level of group B were lower than those of group A,（P〈0.05）.The level of TNFα at R2 in group C was （2.94±0.382）ng/mL,were significantly lower than that of group B. It＇s （4.15±0.495）ng//mL（P〈0.05）.（3）The damdge of liver tissue in group C were significantly slighter than those of group B.Under the light microscope.Conclusion Aprotinin have protective effects on the intestinal isehemia-reperfusion, inhibt the level of lipid peroxidation,and the damage on intestinal in the intestinal isehemia--reperfusion.At meantime,Its marked that protective effect of aprotinin on the intestinal.
出处
《中外医疗》
2009年第23期10-13,共4页
China & Foreign Medical Treatment
