丙酮酸乙酯对脓毒症大鼠肠黏膜屏障功能保护作用的研究  

Effects of ethyl pyruvate on barrier function of intestinal mucosa in septic rats

作　　者：詹剑勇[1] 梅冰[1] 王美堂[1] 霍正禄[1] 

机构地区：[1]解放军第二军医大学附属长海医院急诊科,上海200433

出　　处：《中国急救医学》2009年第12期1105-1108,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的观察丙酮酸乙酯（ethyl pyruvate，EP）干预治疗对脓毒症大鼠生存率和肠黏膜屏障的影响。方法①EP对脓毒症大鼠生存率的影响：无特定病原雄性SD大鼠100只随机分为假于术组（A组）、脓毒症组（B组）、EP早期治疗组（C组）及EP延迟治疗组（D组），每组25只，利用盲肠结扎穿孔法（cecal ligation and puncture，CLP）制作大鼠脓毒症模型，各组均于术后6、12、18、24、36、48、60、72h腹腔内注射给药3mL，C、D组分别于术后6、12h开始予EP（40mg／k），A、B两组同法予等量林格乳酸钠溶液（mger lactate solution，RLS），每隔12h记录死亡情况，分析比较5d生存率；②EP对脓毒症大鼠肠黏膜屏障的影响：80只无特定病原雄性sD大鼠随机分为四组，每组20只，分组及给药方法与方法一相同，术后24、48h各处死10只。测定各时间点血浆D-乳酸、DAO的变化，同时用透射电镜观察术后48h肠黏膜上皮细胞超微结构的变化。采用Kaplan—Meier生存分析法进行生存分析，多组均数间比较采用单因素方差分析的方法，多组均数间两两比较采埔SNK—q检验，P〈0．05为差异有统计学意义。结果A、B、C、D四组大鼠5d生存率分别为100％、24％、68％、56％，与B组相比，C、D组大鼠5d生存率明显提高（P〈0．05），C、D组间差异无统计学意义（P〉0．05）；与B组相比，c、D组术后24h和48hm浆D-乳酸含量明屁下降（P〈0．01）；与B组相比，c组、D术后24h和48h血浆DAO活性明显下降（P〈0．01），C、D组术后24、48h血浆D-乳酸含匿、DAO活性差异无统计学意义（P〉0．05）；电镜下c、D组肠黏膜上皮细胞损伤较B组明显减轻，细胞间紧密连接较清楚。结论脓毒症时肠黏膜损伤严重，EP早期与延迟干预治疗能有效保护肠黏膜屏障，提高5d生存率，具有抗脓毒症作用。Objective To observe the effects of ethyl pyruvate （EP） on the survival rate and the intestinal mucosa barrier in septic rats. Methods ①Effect of EP on the survival rate of septic rats ： one hundred SPF - grade male Sprague - Dawley rats were randomly divided into 4 groups ： sham group （ group A） , sepsis group（ group B） ,early treatment with EP group（ group C） and delayed treatment with EP group（ group D}. A cecum ligation and puncture procedure was used to make sepsis model. Drugs were injected intraperitoneally at 6,12,18,24,36,48,60 and 72 hours after operation. Sham group and sepsis group were administrated with 3ml ringer lactate solution（RLS） ,whereas early treatment group（6 h after CLP） and delayed treatment group（ 12 h ＇alter CLP） were treated with ringer ethyl pyruvate solu- tion（REPS） 3 mL （ EP 40 mg/kg body weight）. The survival period of rats was observed within 5 days after operation. ②Effeet of EP on tile intestinal mucosa barrier in septic rats. ： Eighty SPF - grade male Sprague - Dawley rats were randomly divided into 4 groups. Grouping and administration methods were were the same as above. Ten rats from each group were sacrificed 24 and 48 hours after operation. Concentration of D - lactate and activity of DAO in plasma were measured at each phase points and ultra- structure of the intestinal mueosa were observed under electron microscopy 48 hours after operation. Kap- lan - Meier test was used for comparing survival. Data were analyzed for significance by one - way ANO- VA including SNK - q test. Two - tailed tests of significance were employed and significance was assumed at P 〈 0.05. Results Five day survival rate of group A, B, C and D was 100% 124% , 68%, 56% respectively. Compared with group B, 5 -day survival rate of rats in group C and D was significant- ly improved （ P 〈 0.05 ） , but no significant differences were found between group C and D （ P 〉 0.05 ）. In group C and D, the concentration of D -lactate in plasma was sig

关 键 词：丙酮酸乙酯 脓毒症 生存率 肠黏膜屏障 

分 类 号：R714.627[医药卫生—妇产科学]