生长激素对肝大部切除术后鼠肠黏膜的保护作用  

Protective function of human growth hormone on intestinal mucosa barrier of rats after major hepatectomy

作　　者：梁道明[1] 石刚[2] 陈嘉勇[1] 张毅[1] 林劼[1] 赵辉[1] 林丰[1] 

机构地区：[1]昆明医学院第二附属医院急诊外科,云南昆明650101 [2]川北医学院附属医院普外科,四川南充637100

出　　处：《肝胆胰外科杂志》2005年第1期33-35,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的 :探讨鼠肝大部切除术后生长激素对肠黏膜屏障的保护作用 ,为临床使用重组人生长激素保护肠黏膜提供实验依据。方法 :90只SD大鼠随机分为对照组、生理盐水 (normalsaline ,NS)组和生长激素 (re combinanthumangrowthhormone,rhGH)组 ,后两组切除肝左叶和右叶 ;各组连续用药 6d ,分别于术后第 1,2 ,3,5和 10天取回肠组织行光镜形态学观察及图像分析检测肠黏膜厚度和绒毛高度 ,并对回肠黏膜上皮细胞行核增殖抗原 (proliferatecellnucleusantigen ,PCNA)免疫组织化学测定 ;取心脏血 4～ 6ml,检测内毒素。结果 :肝大部分切除术后第 1,2天 ,内毒素明显升高 ,而rhGH组与对照组无明显差异。术后第 3,5天 ,回肠黏膜明显萎缩 ,绒毛变薄 ;黏膜上皮细胞PCNA明显下降 (P <0 .0 1)。应用rhGH 3d后 ,回肠绒毛高度、黏膜厚度和PCNA度均增加 (P <0 .0 1) ;术后第 5天 ,达到对照组水平。结论 :肝大部分切除术后肠黏膜屏障受损 ,应用rhGH可保护肠黏膜屏障 ,减少血浆内毒素水平。Objective:To investigate the protective effects of growth hormone(GH) on intestinal mucosa barrier in rats,and to provide the experimental gist for using recombinant human growth hormone(rhGH) after 70% hepatectomy.Methods:Ninety rats were randomized into control,NS and rhGH groups,hepatic left and right lobe of rats in NS and rhGH groups were resected in the latter two groups. Drug was injected continuosly for 6 days. On post-operative 1st,2nd,3rd,5th and 10th day,thickness of mucosa and height of villi of rat ileum were examined by the image analysis instrument and morphology of ileum was observed;proliferate cell nucleus antigen(PCNA) of ileum mucosal epithelium was determined by immunohistochemical technique. In addition,the content of plasma endotoxin was examined on post-operative 1st,2nd and 3rd day.Results:On the 1st and 2nd day of 70% hepatectomy,endotoxin evidently rose,but it was not markedly different between rhGH group and control group. Ileum mucosa distinctly shrunk and villi thinned and PCNA of ileum mucosal epithelium distinctly descended(P<0.01) on 3rd,and 5th day. Above results evidently rose on the 3rd day of using rhGH(P<0.01) and were as same as control group on the 5th day.Conclusion:The intestinal mucosa barrier is damaged after major hepatectomy and rhGH therapy can protect markedly the intestinal mucosa barrier and reduce endotoxemia.

关 键 词：生长激素 肝大部切除 肠黏膜屏障 内毒素 核增殖抗原 

分 类 号：R657.3[医药卫生—外科学]