乌斯他丁对大鼠门静脉阻断后肠粘膜屏障影响实验探究.docVIP

乌斯他丁对大鼠门静脉阻断后肠粘膜屏障影响实验探究 　 作者：徐敬 何建平 郑南 杨福 邬明 沈骅 　【摘要】目的：探讨阻断大鼠门静脉对肠屏障功能的影响以及乌斯他丁对其损害的保护作用，为临床门静脉阻断后肠屏障功能的保护提供实验依据。方法：SD大鼠70只，随机分为对照组（n=10）、手术组（n=30）、手术+药物组（n=30）。手术组及手术+药物组门静脉阻断时间为40min，门静脉复流4h。70只动物均于手术后4h 40min在无菌条件下取门静脉血2ml检测内毒素：取回盲部肠系膜淋巴结作细菌培养；距回盲部2cm处取小肠肠壁组织1cm，作病理学检查，观察肠粘膜通透性及其形态学结构改变。结果：对照组与手术组比较，大鼠门静脉阻断后其门静脉血内毒素水平明显上升；肠系膜淋巴结细菌培养阳性率增加；小肠壁形态学结构亦发生明显改变。手术+药物组与手术组比较，上述指标均有改善。结论：大鼠门静脉阻断后可导致其肠屏障功能的损害，乌斯他丁对上述损害具有保护作用。 【关键词】门静脉阻断#12539;肠粘膜屏障#12539;乌斯他丁#12539;大鼠 Effects of ulinastatin on intestinal mucosal barrier after occlusion of portal vein in rats 【ABSTRACT】Objective:To study the effect of portal vein occlusion on intestinal mucosal barrier in rats and the protection of ulinastatin to the injury,to present the experimental data for the clinical surgery.Methods:70 SpragueDawley rats were randomly divided into controlled group (n=10),operation group (n=30) and operation+medication group (n=30).The portal vein were occlused 40 min in the operation groups and operation+medication groups.2ml blood from portal vein,lymph nodes around appendix,1cm small intestine wall were taken for endotoxin levels,bacterial translocation and pathiology examinations in the all rats 280 mins after operation.The mocusal barrier and microscopic structure of intestine were observed.Results:Compared between the control group and the operation group,endotoxin levels,bacterial translocation rates rise greatly and gut structure change obviously in the latter.Compared between the operation group and operation+medication group,the former changes is also obvious.Conclusion:The occlusion of portal vein can leads the decrease of intestine mocusal barrier and the increase of its permeability.Ulinastatin has a good protective effect on the damages above. 【KEY WORDS】Occlusion of portal vein#12539;Intestinal mocusal barrier#12539;Ulinastatin#12539;Rats 门静脉血流阻断（portal vein occlusion,PVO）技术是肝胆外科及胰腺外科常用的手术操作方法。然而，门静脉阻断可导致肝脏及肝外器官的损伤［1］，其中肠屏障功能损害是其主要并发症之一。预防和治疗肠屏障功能障碍是基础研究和临床研究的重点。本实验通过建立大鼠门静脉阻断动物模型，