人重组生长激素对梗阻性黄疸大鼠肠源性细菌/内毒素移位的影响  

Effects of recombinant human growth hormone on intestinal bacteria/endotoxin translocation in rats with obstructive jaundice

作　　者：毛晓光[1] 杨志伟[1] 李建国[1] 丛玉萍[2] 佟忠山[3] 孙海英[3] 李秀荣[4] 

机构地区：[1]黑龙江省医院普外科,哈尔滨市150036 [2]黑龙江省医院手术室,哈尔滨市150036 [3]黑龙江省医院检验科,哈尔滨市150036 [4]黑龙江省医院病理科,哈尔滨市150036

出　　处：《中华肝胆外科杂志》2005年第6期407-410,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：黑龙江省科学技术厅留学回国基金资助项目(20010701)

摘　　要：目的探讨人重组生长激素(rhGH)减轻梗阻性黄疸时肠源性细菌及内毒素移位的作用及机制。方法Wister大鼠42只分为3组假手术组(SO组)、胆总管结扎组(BDL组)及rhGH治疗组(rhGH组)。实验1周后检测各组肝功指标的变化及血浆内毒素水平,取肝、肾、肠系膜淋巴结等肠道外器官组织做细菌培养,电镜观察末端回肠黏膜变化。结果rhGH组多项肝功指标较BDL组明显改善,rhGH组血浆内毒素水平为(0·38±0·03)EU/ml,较BDL组的(0·65±0·04)EU/ml明显降低(P<0·01),与SO组的(0·30±0·02)EU/ml比较无显著差异(P>0·05)。BDL组肝、肾、肠系膜淋巴结中细菌移位率高于另两组,其中肠系膜淋巴结细菌移位率为64·29%,明显高于SO组及rhGH组(P<0·05),后两组之间各部位细菌检出率差别无显著性(P>0·05)。电镜显示BDL组肠黏膜上皮细胞坏死,细胞核固缩,线粒体肿胀变性,内质网明显扩张。rhGH组肠黏膜上皮改变较BDL组明显减轻,接近SO组所见。结论应用rhGH可保护梗阻性黄疸时小肠黏膜屏障功能,减少肠源性细菌/内毒素移位的发生。Objective To investigate the effects of recombinant human growth hormone (rhGH) on intestinal bacteria/endotoxin translocation in rats with obstructive jaundice. Methods Forty-two Wistar rats were randomized into the sham operation (SO) group, bile duct ligation (BDL) group and BDL and rhGH treatment group. After the experiment was conducted for 7 d, the animals were killed to determine the liver function and blood level of endotoxin. Meanwhile, the bacterial culture of the liver, kidney and mesenchymal lymph was performed. Terminal ileum mucosa was observed under the electron microscope. Results The liver function was significantly improved in rhGH group than in BDL group. The value of endotoxin in rhGH group was significantly lower than that in BDL group (0.38±0.03 EU/ml vs. 0.65±0.04 EU/ml, P<0.05) and similar to that in SO group (0.38±0.03 EU/ml vs. 0.30±0.02 EU/ml, P>0.05). The bacterial translocation rate in liver, kidney and mesenchymal lymph was significantly higher in BDL group than in the other 2 groups (P<0.05). There was no marked difference in bacterial translocation rate between the SO group and rhGH group (P>0.05). The electron microscopy showed that the ileum mucosa epithelial cells BDL group were necrotic, organelle were markedly metamorphic. In rhGH group, the ultrastructural pathology was much less evident and similar to that in SO group. Conclusions rhGH has significant beneficial effects on protecting intestinal mucosa barrier in obstructive jaundice and can reduce intestinal bacteria/endotoxin translocation.

关 键 词：细菌/内毒素移位 人重组生长激素 梗阻性黄疸 肠系膜淋巴结 WISTER大鼠 rhGH 内毒素水平 肝功指标 细菌移位 肠源性细菌 胆总管结扎 细菌检出率 线粒体肿胀 细菌培养 器官组织 回肠黏膜 电镜观察 细胞坏死 屏障功能 小肠黏膜 

分 类 号：R575[医药卫生—消化系统]