肝门阻断对大鼠肠道细菌移位和内毒素血症的影响  

Bacterial Translocation and Endotoxemia Following Pringle Maneuver in Rats

作　　者：苏永辉[1] 贾英斌[1] 潘海燕[1] 郭兆旺[1] 谢玉研[1] 张百萌[1] 

机构地区：[1]中山大学附属第五医院普通外科,广东珠海519000

出　　处：《中山大学学报（医学科学版）》2010年第6期867-871,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：珠海市科技局医药卫生重大项目(PB20081002)

摘　　要：【目的】探讨大鼠肝门阻断后肠道细菌移位、内毒素血症情况及肝硬化模型肝门阻断后细菌移位特点。【方法】将40只非肝硬化雄性SD大鼠及40只肝硬化模型雄性SD大鼠分别随机分为假手术组(n=10)、肝门阻断10min(n=10)、20min(n=10)、30min组(n=10),在行肝门阻断手术24h后分别取肠系膜淋巴结、肝、肺及门、腔静脉血作细菌培养,并取门、腔静脉血作内毒素检测。【结果】非肝硬化大鼠肝门阻断30min组门、腔静脉血内毒素浓度(EU/mL0.18±0.05、0.17±0.06)明显高于假手术组(EU/mL0.12±0.03、0.11±0.03),肠系膜淋巴结细菌培养呈阳性。肝硬化大鼠肝门阻断20min组门、腔静脉血内毒素浓度(EU/mL0.42±0.09、0.35±0.07)明显高于假手术组(EU/mL0.15±0.04、0.14±0.03),并随肝门阻断时间延长升高越明显,肠系膜淋巴结、肝及门、腔静脉血细菌培养出现阳性,且随肝门阻断时间延长阳性率升高越明显,培养出阳性细菌主要为大肠杆菌。在肝门阻断20、30min下肝硬化大鼠比非肝硬化大鼠门、腔静脉血内毒素浓度升高更明显(P<0.01),出现细菌移位阳性率也更高。【结论】大鼠肝门阻断后可导制内毒素血症及肠道细菌移位,这一病理过程在肝硬化情况下更容易出现,并且随肝门阻断时间延长而更加明显。【Objective】 To investigate the effects of Pringle maneuver （Pm） on systemic bacterial translocation （BT）,endotoxemia in non-cirrhotic rats and cirrhotic rats. 【Methods】 A total of 40 male SD non-cirrhotic rats and 40 male SD cirrhotic rats was randomly divided into four equal groups：sham operation （n = 10）,Pm of 10 min （n = 10）,Pm of 20 min （n = 10） and Pm of 30 min （n = 10）,respectively. Tissue samples from mesenteric lymph nodes （MLNs）,liver,lungs,portal and vena cava blood were obtained for cultures after 24 h of operation. Endotoxin was measured in portal and vena cava blood after 24 h of operation. 【Results】 Portal and vena cava endotoxin levels in Pm of 30 min group （EU / mL 0.18 ± 0.05,0.17 ± 0.06） were significantly higher than in sham operation group （EU / mL 0.12 ± 0.03,0.11 ± 0.03） in non-cirrhotic rats,and there was also a significant increase in contaminated MLNs. While portal and vena cava endotoxin levels in Pm of 20 min group （EU / mL 0.42 ± 0.09,0.35 ± 0.07） were significantly higher than in sham operation group （EU / mL 0.15 ± 0.04,0.14 ±0.03） in cirrhotic rats,and a significant increase in contaminated MLNs,liver,portal and vena cava blood was noted. The concentration of endotoxin and incidence of gut bacteria translocation turned higher with the time of Pm. E. coli was the most common bacteria isolated from the tissues. In the group of Pm of 20 min and Pm of 30 min,there were a significant higher of endotoxin concentration in portal and vena cava （P 0.01） and incidence of gut bacteria translocation in cirrhotic rats than in non-cirrhotic rats. 【Conclusions】 There is endotoxemia and gut bacteria translocation after occlusion of the hepatoduodenal ligament in rats,especially in cirrhotic rats. The concentration of endotoxin and incidence of gut bacteria translocation turn higher with the time of Pm.

关 键 词：肝门阻断 细菌移位 内毒素血症 肝硬化 

分 类 号：R657.3[医药卫生—外科学]