乌司他丁对脓毒症大鼠肠黏膜上皮防御屏障的影响  

Effects of ulinastatin on gut mucosal epithelial defense barrier in the rat following sepsis

作　　者：张萌[1] 蒋龙元[1] 杨正飞[1] 常建星[1] 李旷怡[2] 温立强[1] 吴畏[1] 常瑞明[1] 

机构地区：[1]中山大学附属第二医院急诊科,广东广州510120 [2]广东省佛山市第一人民医院急诊科

出　　处：《中国中西医结合急救杂志》2009年第1期45-48,65,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广东省自然科学基金项目（06021323）

摘　　要：目的探讨乌司他丁（UTI）对脓毒症大鼠肠黏膜上皮防御屏障的影响。方法50只SD大鼠被随机分为对照组、模型组、UTI预处理组及UTI治疗组，后3组再按盲肠结扎穿孔术（CLP）后3、6和12h分为3个亚组，每个亚组5只。采用改良的CLP制备大鼠脓毒症模型，预处理组在CLP前2h经尾静脉注射UTI25kU／kg，治疗组在CLP后2h经尾静脉注射UTI50kU／kg。分别于CLP后3、6和12h活杀大鼠，取回肠黏膜光镜下观察组织病理学变化，用逆转录-聚合酶链反应（RT—PcR）检测肠黏膜防御素-5（RD-5）和肠三叶因子家族3（TFF3）的mRNA表达水平。结果模型组小肠绒毛顶端上皮脱落，固有层崩解，毛细血管出血和溃疡形成，UTI治疗组和预处理组能显著减轻上述改变。模型组RD-5和TFF3的mRNA表达水平较对照组显著降低，UTI治疗组和预处理组能显著升高其表达水平（P〈0．05或P〈0．01）；预处理组CLP后12h较治疗组升高最为显著，差异有统计学意义（P均〈0．05）。结论脓毒症时肠黏膜上皮屏障功能受损，UTI对其有保护作用，从而遏制脓毒症的发生发展。Objective To investigate the effects of ulinastatin on gut mucosal epithelial defense barrier in a rat model of sepsis. Methods Fifty rats were randomly divided into control group, model group, ulinastatin pretreatment group and ulinastatin treatment group. The latter three groups were further divided into three subgroups, with 5 rats in each subgroup, with treatment 3, 6 and 12 hours after cecal ligation and punture （CLP）. Sepsis was induced by modified CLP. Rats in the pretreatment group received 25 kU/kg ulinastatin 2 hours before CLP, and the rats in treatment group received 50 kU/kg ulinastatin 2 hours after CLP. At 3, 6 and 12 hours after CLP, the ileum was removed, and the pathological changes in mucosa were examined, and mRNA expression of rat defensins-5 （RD-5） and trefoil factor family 3 （TFF3） were determined by reverse transcription-polymerase chain faction （RT-PCR）. Results The pathological changes in model group included loss of villi of ileal epithelial cells and ulceration and hlehbing of the lamina propria. Ulinastatin pretreatment and treatment decreased these morphological abnormalities. The model group rats showed significant decrease in expression of RD-5 and TFF3 mRNA compared with control group; the ulinastatin pretreated and treated rats showed significant increase in expression of RD-5 and TFF3 mRNA, compared with model group （P〈0. 05 or P〈0. 01）; ulinastatin pretreated rats had an extremely significant increase in expression of RD-5 and TFF3 mRNA 12 hours after CLP, compared with rats in ulinastatin treatment group, the difference had statistical significance （both P〈0. 05）. Conclusion Intestinal musocal epithelial defense barrier is impaired in sepsis, and ulinastatin can effectively protect it, thus to contain the development of sepsis.

关 键 词：乌司他丁 脓毒症 肠道 防御素-5 肠三叶因子家族3 

分 类 号：R365[医药卫生—病理学] R965[医药卫生—基础医学]