缺血预处理减轻胰腺移植受体大鼠小肠肠黏膜屏障的损害(英文)  

Ischemic preconditioning lessens the damage of small intestinal mucosal barrier after pancreas transplantation in rats

作　　者：刘小南[1] 霍婷婷[2] 王为忠[1] 管文贤[1] 董光龙[1] 

机构地区：[1]解放军第四军医大学西京医院胃肠外科,陕西省西安市710033 [2]解放军第四军医大学西京医院麻醉科,陕西省西安市710033

出　　处：《中国组织工程研究与临床康复》2007年第29期5846-5849,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:胰腺移植过程中的缺血再灌注损伤可以引起术后众多的并发症,其中继发性胰腺炎可以导致受体小肠黏膜的损伤,造成严重的后果。目的:观察缺血预处理对大鼠胰腺移植受体肠黏膜屏障的保护作用。设计:随机对照动物实验。单位:解放军第四军医大学西京医院胃肠外科。材料:实验于2001-09/2004-04在解放军第四军医大学西京医院胃肠外科实验室完成。动物为SD雄性大鼠83只。方法:①取47只大鼠,自阴茎静脉注射脲链霉素65mg/kg制备糖尿病大鼠模型。将造模成功的36只大鼠随机分为缺血再灌注组,供体缺血预处理组(DIPC组),受体双后肢缺血预处理组(RIPC组)3组,每组12只。剩余36只正常大鼠中随机取12只为对照组,另外24只为供体。②对照组仅行开腹术,其他3组行胰腺移植。DIPC组于获取供胰前阻断供体脾血管5min再灌注5min2次;RIPC组于供胰再灌注前阻断受体双后肢血流5min再灌注5min,重复3次;缺血再灌注组不作处理。主要观察指标:①手术后5d各组随机取6只大鼠检测小肠通透性(以血浆中FITC-dextran浓度表示)和吸收功能(以血浆中木糖浓度表示)。②各组其余6只大鼠于术后5d取血检测血清肿瘤坏死因子α、NO、超氧化物歧化酶和淀粉酶活性,取回肠黏膜组织检测小肠黏膜黏膜湿重、微绒毛高度及宽度、丙二醛含量及髓过氧化物酶活性,同时取肠系膜淋巴结、肝及脾组织进行细菌培养,观察细菌易位情况。结果:经补充后72只大鼠进入结果分析。①血浆中FITC-dextran浓度:缺血再灌注组高于对照组、DIPC组和RIPC组(P<0.01)。②血浆中木糖浓度:缺血再灌注组低于对照组、DIPC组和RIPC组(P<0.01)。③细菌易位率:缺血再灌注组高于对照组、DIPC组和RIPC组(P<0.01)。④小肠黏膜损伤程度:缺血再灌注组低于其他3组(P<0.01)。⑤缺血再灌注组小肠髓过氧化物酶活性和丙二醛含量显著高于其他3组(BACKGROUND： Ischemia/reperfusion （IR） injury during the pancreas transplantation can cause numerous postoperative complications, among which, secondary pancreatitis can cause small intestinal mucosal injury and result in severe consequence. OBJECTIVE： To observe the protective effect of ischemic preconditioning （IPC） on small intestinal mucosal barrier after pancreas transplantation in rats. DESIGN： Randomized controlled animal tria SETTING ： Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA. MATERIALS： This trial was done in the Laboratory of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medica University of Chinese PLA between September 2001 and April 2004. Eighty-three male SD rats were involved in this trial METHODS： Forty-seven rats were randomly chosen to prepare diabetic rat models by penile-intravenous injection of 65 mg/kg streptozotocin. Thirty-six successful model rats were randomized into 3 groups, with 12 in each group： IR group, donor IPC （DIPC） group and recipient with two hindlims IPC （RIPC） group. Twelve of the remaining 36 normal rats served as control group, and the other 24 rats were used as donors. Laparotomy was conducted only in control group, and pancreas transplantation was conducted in the other 3 groups. In DIPC group, the splenic vessels of donors were blocked for 5 minutes and reperfused for 5 minutes twice before obtaining pancreas from donor; In the RIPC group, blood flow of two hindlimbs of recipients was blocked for 5 minutes and reperfused for 5 minutes before reperfusing the pancreas of donor, and this procedure was repeated 3 times. IR group was untouched. MAIN OUTCOME MEASURES：①On the 5^th day after operation, 6 rats were randomly chosen from each group to detect small intestinal permeability [expressed with plasm fluorescent- isothiocyanate-dextran （FITC-dextran） concentration] and absorption function （expressed with plasm xylose concentration）. ②On the 5^th day a

关 键 词：胰腺移植 缺血预处理 肠黏膜 大鼠 

分 类 号：R617[医药卫生—外科学]