化学改性壳聚糖膜及透明质酸钠对缺血性腹膜粘连的预防作用  

Preventive effects of chemically-modified chitosan film with sodium hyalurate on the ischemia-induced peritoneal adhesion

作　　者：江素君[1] 周卸来[2] 倪有娣[2] 茹金泉[2] 杜红英[2] 郑婷[2] 胡巧玲[3] 

机构地区：[1]杭州师范大学医学实验中心,浙江省杭州市310036 [2]杭州师范大学临床医学院,浙江省杭州市310036 [3]浙江大学高分子复合材料研究所,浙江省杭州市310027

出　　处：《世界华人消化杂志》2009年第10期1025-1029,共5页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.50173023~~

摘　　要：目的:探讨化学改性壳聚糖膜和透明质酸钠对缺血性腹膜粘连的预防作用.方法:SD大鼠60只,随机分成3组:生理盐水对照组(A组)、化学改性壳聚糖膜组(B组)和透明质酸钠组(C组).利用大鼠蚓突盲端制作缺血性腹膜粘连模型,然后每组分别用相应的方法处理创面,处理后2、4wk打开腹腔,以Phillips五级分类法评定蚓突盲端的粘连程度,并对盲端组织行羟脯胺酸(OHP)水平测定.结果:术后2、4wk,B、C组的粘连程度均显著轻于A组(2wk:U=3.000,8.500,P<0.001,P=0.001;4wk:U=2.000,14.000,P<0.001,P=0.003),OHP水平显著低于A组(2wk:0.193±0.029mg/mgpr,0.253±0.028mg/mgprvs0.296±0.031mg/mgpr,均P<0.01;4wk:0.179±0.034mg/mgpr,0.237±0.035mg/mgprvs0.286±0.036mg/mgpr,均P<0.01);B组和C组比较,前者的粘连程度显著轻于后者(P=0.038,0.015),OHP含量显著低于后者(P<0.001,P=0.001).结论:化学改性壳聚糖膜具有明显的抗腹膜粘连作用,且此作用较透明质酸钠具有优势.AIM： To comparatively study the preventive effects of chemically-modified chitosan film with sodium hyalurate on the ischemia-induced peritoneal adhesion in rats. METHODS： Sixty Sprague-Dawley rats were randomly divided into saline-control group （Group A）, chemically-modified chitosan film group （Group B） and sodium hyalurate group （Group C）, respectively. The ischemia-induced peritoneal adhesive model was established in the caecums of vermiform processes of the rats, and the ischemia surfaces were correspondingly treated with saline, chemically-modified chitosan film and sodium hyalurate in Group A, B and C. After two and four weeks of the treatments, the abdominal cavities were reopened and the adhesive severity was graded blindly according to the Phillips＇ method. The caecums of vermiform processes were resected for hydroxyproline （OHP） measurement. RESULTS： After two and four weeks of the treatments in group B and C, the adhesions were significantly lighter （2 wk： U = 3.000, 8.500, P 〈 0.001, P= 0.001; 4 wk： U = 2.000, 14.000, P 〈 0.001, P = 0.003） and the OHP levels were significantly lower （2 wk： 0.193 ± 0.029 μg/mg pr, 0.253 ± 0.028 μg/mg pr vs 0.296 ± 0.031 μg/mg pr, both P 〈 0.01; 4 wk： 0.179 ± 0.034 μg/mg pr, 0.237 ± 0.035 μg/mg pr vs 0.286 ± 0.036 μg/mg pr, both P 〈 0.01） than those of Group A, respectively. When group B was compared with group C, the former＇s adhesions were significantly lighter （P = 0.038, P = 0.015） and the OHP levels were significantly lower （P 〈 0.001, P = 0.001）. CONCLUSION： The chemically-modified chitosan film is more effective in preventing peritoneal adhesion induced by ischemia than that of sodium hyalurate.

关 键 词：壳聚糖 化学改性 透明质酸 腹膜粘连 

分 类 号：R656.4[医药卫生—外科学]