肠缺血再灌注肠P-选择素表达与肠损伤的关系  

Anti-p-selectin antibody treatment in intestinal ischemia-reperfusion injury

作　　者：顾志成[1] 刘维明[1] 孙庆林[1] 王兴东[2] 季正华[2] 张志德[3] 

机构地区：[1]苏州大学附属儿童医院外科,215003 [2]苏州大学附属儿童医院儿科研究所,215003 [3]苏州大学附属第一医院外科

出　　处：《中华小儿外科杂志》2005年第10期548-550,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨肠缺血再灌注损伤时肠血管内皮细胞P-选择素蛋白的表达及P-选择素单克隆抗体在抗肠损伤方面的作用。方法夹闭肠系膜上动脉制作大鼠肠缺血再灌注模型,应用免疫组织化学的方法观察小肠P选择素表达的变化,同时检测肠组织、血二胺氧化酶(DAO)活性及髓过氧化物酶(MPO)活性的变化。结果血DAO活性在再灌注60min时达高峰(1.27±0.19)u/ml;肠组织中DAO活性假手术组(1.12±0.14)u/mgpro,再灌注60min组为(0.50±0.13)u/mgpro,P<0.01。血MPO活性假手术组为(46.16±6.19)u/l,再灌注30min达高峰(148.83±22.80)u/l,P<0.01,小肠组织P-选择素蛋白表达显著;而在再灌注同时给予P-选择素单克隆抗体治疗,再灌注30min,血MPO活性可见明显降低为(70.17±17.70)u/l。结论肠缺血再灌注过程中肠血管内皮细胞P-选择素表达上调,可能在介导中性粒细胞聚集、活化并导致早期肠黏膜损伤中发挥重要作用,应用P-选择素单克隆抗体可有效地防治肠缺血再灌注损伤。Objective To investigate the expression P-selectin following intestinal ischemia reperfusion injury. Methods Murine intestinal ischemia reperfusion models were created by clamping the superior mesenteric artery（SMA）, The levels of P-selectin were assayed by immunohistochemistry and the gut myeloperoxidase （MPO）activity, the plasma diamine oxidase （DAO）level were also determined. Results The plasma DAO activity peaked at 1 h post - reperfusion （1.27 ± 0. 19 u/ml） ;intestinal tissue DAO activity at 1 h postreperfusion （0. 50 ± 0. 13 u/mgpro） were lower compared to the sham group （ 1.12 ±0. 14 u/mgpro）, P〈0. 01 ; serum MPO activity peaked at 30 min post-reperfusion （148.83± 22.80 u/l） and its level in sham group was 46. 16 ± 6. 19 u/l P〈0. 01. Serum MPO activity showed obvious improvement （70. 17 ± 17. 70u/l） with using anti-p-selectin antibody at the beginning of reperfusion , P〈0. 05. And there were obvious brown positive granule in intestinal tissue at 30 min post-reperfusion. Conclusions The aggregation and activation of polymorphonuclear （PMN） in intestinal tissue is associated with the high expression of P-selectin on intestinal vascular endothelial cells following intestinal ischemia reperfusion injury, p-selectin antibody could be applied to minimize damage in ischemia-reperfusion injury.

关 键 词：局部缺血再灌注损伤 P选择素 过氧化物酶 肠缺血再灌注损伤 P-选择素 肠损伤 DAO活性 肠缺血再灌注模型 血管内皮细胞 单克隆抗体 

分 类 号：R726.5[医药卫生—儿科]