血管紧张素转换酶抑制剂促进短肠综合征大鼠肠黏膜的适应性代偿  

Angiotensin converting enzyme inhibitor improves bowel adaptation in a massive intestinal resection rat model

作　　者：王文生[1] 肖卫东[1] 张朝君[1] 陈炜[1] 孙力华[1] 杨桦[1] 

机构地区：[1]第三军医大学新桥医院普通外科

出　　处：《重庆医学》2010年第10期1203-1205,1208,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(NSFC30973113);国家教育部回国留学人员基金资助项目(2007);重庆市自然科学基金重点项目(CSTC2008BA5006);第三军医大学回国人员基金资助项目(2007)

摘　　要：目的通过SD大鼠短肠综合征(SBS)模型,研究血管紧张素转换酶抑制剂(ACEI)对肠黏膜的保护作用及其机制。方法成年雄性SD大鼠18只,采用随机数字表法分为3组:Sham组(空回肠单纯离断吻合)(n=6);SBS组(切除大约75%中段小肠,n=6);ACEI组[(SBS+ACEI)2 mg.kg-1.d-1](n=6)。术后10 d取材,测量大鼠小肠绒毛高度和黏膜层厚度,TUNEL法检测肠上皮细胞凋亡情况,RT-PCR技术检测肠黏膜ACE mRNA表达。结果术后ACEI组体质量恢复速度快于SBS组,但二者都明显慢于对照组(P<0.05)。SBS组黏膜绒毛较对照组明显增生肥大,绒毛高度和隐窝深度(总高度)增加约50%[(778±30)μmvs(502±40)μm,P<0.01],给予ACEI后,肠黏膜厚度较SBS组增高更明显[(870±29)μmvs(778±30)μm,P<0.01],75%小肠切除引起了残留肠段肠上皮细胞凋亡的显著增加[(5.46±0.95)%vs(1.01±0.49)%,P<0.05],给予ACEI显著抑制了肠切除所引起的残留肠段肠上皮细胞凋亡的增加[(2.39±0.70)%,P<0.05]。SBS组ACEmRNA水平较对照组明显增高,给予ACE抑制剂后ACE水平进一步增高(P<0.05)。结论肠切除后ACE的升高与上皮重塑密切相关,ACEI的应用可以抑制肠上皮细胞凋亡,促进肠黏膜适应性代偿。Objective To investigate the effects of angiotensin converting enzyme inhibitor（ACEI）on the bowel adaptation in a massive intestinal resection rat model.Methods Sprague-Dawley rats were used,and divided into three groups：sham group,received ileum transection（n=6）;SBS group,received 75% mid-intestinal resection（n=6）;SBS＋ACEI group,received 75% mid-intestinal resection and lavaged with ACEI（enalaprilat,2 mg·kg-1·d-1）（n=6）.All rats were provided with ordinary rat chow ad libitum.Sampling was done on 10 d after resection.ACE expression was detected with RT-PCR and immunofluorescent confocal microscopy.Results Massive bowel resection led to significant intestinal hypertrophy.There was an increase in both villus height and crypt depth（total height） in the SBS group.Total height was increased about 50% compared with the sham group[（778±30） μm vs（502±40）μm,P0.01],and the total height of intestinal mucosa in SBS＋ACEI group was about 14% higher than that in SBS group（P0.01）.Additionally,ACEI administration in SBS rat resulted in a significant decline in EC apoptosis（P0.05）.ACE expression was significantly elevated after SBS creation（P0.05）,and ACEI administration further increased ACE expression compared with the SBS group（P0.05）.Conclusion These results offer insight into the role of ACE on intestinal adaptation.ACEI intake can promote the mucosal remolding after massive bowel resection.

关 键 词：短肠综合征 血管紧张素转换酶抑制剂 肠黏膜 结构性代偿 

分 类 号：R96[医药卫生—药理学]