肠屏障损伤后通透性与形态学改变的相关性研究  

Study on correlation between morphological change and intestinal permeability after gut barrier injury

作　　者：常建星[1] 黄子通[2] 蒋龙元[2] 常瑞明[3] 

机构地区：[1]中山大学附属第一医院急诊外科,广东广州510120 [2]中山大学附属第二医院急诊科 [3]中山大学附属第二医院急诊外科,广东广州510120

出　　处：《中国急救医学》2004年第11期806-807,共2页Chinese Journal of Critical Care Medicine

基　　金：广东省科技计划项目资助(2004B30601001)

摘　　要：目的 观察大鼠应激下肠屏障损伤后通透性与形态学改变的相关性研究。方法 建立大鼠失血性休克模型,分别于复苏后1、3、6、12、24 h时间段观察肠黏膜形态学改变,包括常规检查、绒毛改变和肠上皮损伤指数;同时通过口服乳果糖和甘露醇,检测尿中二者的比值的变化来观察肠通透性改变情况。结果 休克复苏后肠道上皮产生明显的损伤改变,复苏后1 h最明显,3 h起局部肠黏膜开始出现修复,6 h大部分修复,24 h肠黏膜结构恢复正常,肠黏膜绒毛高度呈进行性下降;乳果糖甘露醇比值(L/M)于3、6 h达高峰,12、24 h仍高于对照组。结论 应激状态下肠屏障严重受累,其通透性的恢复明显滞后于形态学重建。Objective To observe the correlation between morphological change and intestinal permeability from gut barrier injury of the rats under stress.Method We made experimental rat model of hemorrhagic shock. The morphological change of intestinal mucosa were observed through light and electronic microscope, including histologic examination, determination of villous thickness and evaluation of mucosal damage index in 1,3,6,12 and 24 h after reinstitution, and lactulose mannitol ratio of urine was detected to analyze the change of intestinal mucosal barrier function for studying their relationship. Result The lesions in small intestine were even more obvious in intestinal mucosa, especially in 1 h; it began to reinstitution within 3 h, and most part of managed mucosa was near to reinstitution entirely and finished in 24 h, but villous thickness reduced progressively; Urine lactulose manrutol ratio in the experimental groups raised significantly, reached the peak in 3 and 6 h group respectively,and still increased slightly,compared with control group. Conclusion Intestinal mucosal barrier were subjected to serious damage under stress, the recovery of intestinal barrier function was obviously slower than that of intestinal mucosal morphological changes.There was no direct relationship between the intestinal permeability and its morphological changes.

关 键 词：肠屏障 肠通透性 损伤指数 乳果糖甘露醇比值 

分 类 号：R363[医药卫生—病理学]