N-乙酰半胱氨酸对梗阻性黄疸大鼠肠黏膜屏障的保护作用  

Protective Effect of N-Acetylcysteine on Intestinal Barrier in Obstructive Jaundice of Rats

作　　者：张小龙[1] 邬善敏[1] 许汉兵[1] 占水平[1] 陈志波[1] 

机构地区：[1]武汉大学人民医院肝胆腔镜外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2010年第3期320-323,共4页Medical Journal of Wuhan University

摘　　要：目的:研究N-乙酰半胱氨酸(NAC)对梗阻性黄疸大鼠肠黏膜屏障的保护作用。方法:30只雄性Wistar大鼠随机平均分为3组:假手术组(SO),胆总管结扎组(BDL),胆总管结扎+N-乙酰半胱氨酸组(BDL+NAC)即治疗组。BDL+NAC组大鼠胆总管结扎术后第1天开始,每天腹腔给予NAC(150 mg/kg,腹腔注射,每天1次),而SO、BDL组大鼠每只每天腹腔给予同等剂量生理盐水。在术后第7天检测血浆总胆红素(TBIL)和门静脉血的内毒素水平;比色法测定回肠末端肠道组织匀浆的髓过氧化物酶(MPO)的活性水平;光镜下观察肠道的黏膜厚度和绒毛密度;免疫组化法测定末端回肠组织基质金属蛋白酶-9(MMP-9)的表达水平。结果:BDL组大鼠较SO组血浆TBIL和门静脉血内毒素水平明显升高(P<0.05);肠道黏膜厚度和绒毛密度降低(P<0.05);末端回肠组织MPO活性水平升高(P<0.05);同时末端回肠组织MMP-9表达水平升高(P<0.05)。与BDL组大鼠相比,BDL+NAC组大鼠门静脉血内毒素水平明显降低(P<0.05);肠道黏膜厚度和绒毛密度增加(P<0.05);末端回肠组织MPO活性水平降低(P<0.05);同时末端回肠组织MMP-9表达水平降低(P<0.05)。结论:NAC能够有效减轻肠道黏膜的损伤,改善梗阻性黄疸大鼠肠道屏障功能,降低门静脉内毒素水平。Objective： To study the protective effect of N-acetylcysteine（NAC） on intestine in obstructive jaundice rats.Methods： Thirty male Wistar rats were randomly and equally divided into three groups as sham operation（SO）,bile duct ligation（BDL）,and BDL＋NAC group（150 mg/kg per day NAC intraperitoneal injection after BDL）.On the 7th day,levels of serum total bilirubin and endotoxin level in portal vein blood were measured,myeloperoxidase and MMP-9 of terminal ileum homogenates were determined,and the mucosal thickness and villus density of terminal ileum were examined.Results： Levels of serum total bilirubin and endotoxin in portal vein of rats in BDL group significantly increased;myeloperoxidase level increased,mucosal thickness and villus density of terminal ileum decreased,and MMP-9 expression increased（all P〈0.05）.Compared with those in BDL group,level of endotoxin in portal vein significantly decreased（P〈0.05）;myeloperoxidase decreased,mucosal thickness and villus density of terminal ileum increased,and MMP-9 expression decreased in BDL ＋ NAC group（all P〈0.05）.Conclusion： NAC can decrease the level of intestinal oxidative stress and endotoxemia of portal vein in bile duct ligated rats,and alleviate intestinal mucosal injury.

关 键 词：N-乙酰半胱氨酸 基质金属蛋白酶-9 胆总管结扎 

分 类 号：R657.43[医药卫生—外科学]