猕猴肠缺血再灌注后器官组织病理及功能变化实验研究  

Histopathological and functional changes of vital organs from macaques with intestinal ischemia-reperfusion.

作　　者：谭庆华[1] 胡兵[1] 范华[1] 吴浩[1] 许兰涛[1] 唐承薇[1] 

机构地区：[1]四川大学华西医院国家生物治疗重点实验室人类疾病相关多肽研究室,四川成都610041

出　　处：《中国实用内科杂志：临床前沿版》2006年第9期1407-1410,共4页

基　　金：国家自然科学基金重点项目(30330270)

摘　　要：目的动态观察猕猴肠缺血再灌注(IIR)后重要器官病理及功能变化。方法2005年1月至12月,四川大学华西医院人类疾病相关多肽研究室将15只猕猴随机分成正常对照及IIR2组。IIR组在失血基础上,夹闭5只猕猴肠系膜上动脉,持续1h后松夹恢复血液灌流,记录此后24h内动物的临床表现及心、肺、肝、肾的功能变化和脏器大体及组织病理改变。正常组除不夹闭肠系膜上动脉外,其余同IIR组。结果(1)IIR组瞬间即引起平均动脉压下降30%。14h后平均动脉压下降38.5%,波动幅度增加1.6倍;术前心率(95±13)/min,IIR组14h后显著加快至(193±51)/min,P<0.05;但所有猕猴心肌无明显组织病理改变。(2)在IIR组14h后呼吸频率由(30±3)/min增加到(59±17)/min,腹胀、小肠积气明显,肺、小肠炎性损伤明显。(3)IIR组尿量与IIR前[(33.3±27.2)mL/h]比较,IIR后24h尿量明显下降[(19.9±17)mL/h],P<0.05;血肌酐(Cr)及尿素氮(BUN)分别升高31.6%和77.3%;丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)较IIR前均增加了2倍以上;肝、肾可见明显组织病理损伤。(4)外周血WBC与对照组比较差异无显著性,中性粒细胞(NEUT)百分比升高38%,体温持续<35℃。结论严重IIR持续1h可引起长时间有效循环血容量不足,其组织病理炎性损伤较早发生在富含免疫细胞的脏器,IIR后14h内可能是避免多器官功能障碍综合征(MODS)发生的重要治疗窗口。Objective To get dynamic observation of the functional and histopathological changes of vital organs from macaques with intestinal ischemia reperfusion （ⅡR）. Methods From Jan. 2005 to Dec. 2005, 15 macaques were divided into control or ⅡR group. The flow of superior mesenteric artery of five macaques in ⅡR group was resumed after one- hour＇s obstruction with clamp. The manifestations, the states of circulation and respiratory rates before and after ⅡR were recorded. ALT, AST, creatinine and BUN were before and after ⅡR. The histopathological analysis for vital organs was performed at 24 h after ⅡR. Results （ 1 ） The mean artery pressures were decreased 30% as soon as the superior mesenteric arteries were clamped and went down further to 38.5% at 14 h after ⅡR with 1.6 times increase of variation range. The heart rates of macaques increased from （95± 13） /min before operation to （ 193±51 ） /min at 14 h （P 〈 0.05 ）. Without marked histopathological changes in myocardium. （2） The respiratory rates were increased from （30±3） /min to （59 ±17） /min at 14 h after ⅡR with flatulence of small intestine. （3） The urine volume was decreased from （33.3±27.2） mL/h to （ 19.9 ± 17） mL/h in IIR group, P 〈0.05. The levels of serum creatinine or BUN increased 31.6% or 77. 3% respectively. Serum ALT or AST of macaques after IIR was double more than that before ⅡR. The inflammatory lesions in lung, small intestine, liver and kidney of macaques were impressive. （4） Although WBC in peripheral blood of ⅡR group was no significantly different when compared with that of control group,neutrophils increased 38%. The body temperatures were kept 〈 35 C after ⅡR. Conclusion Severe ⅡR lasting for l h might result in persistent insufficiency of circulative volume. The histopathological inflammatory damages caused by ⅡR occured early in the organs with rich immunological cells. The duration within 14 h after ⅡR might be the crucial therapeutic window to avoi

关 键 词：猕猴 肠缺血再灌注 组织病理学 功能改变 

分 类 号：R5[医药卫生—内科学]