粪便中肠源性防御素-5含量变化对腹腔感染大鼠肠黏膜屏障功能监测的意义  

Clinical value of fecal defensin-5 levels to measure the intestinal mucosa barrier function in rats with abdominal infection

作　　者：杨荣[1] 嵇武[1] 李国逊[1] 刘兴东[1] 范铭兴[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)普通外科,江苏南京210002

出　　处：《中国现代医学杂志》2011年第11期1292-1296,共5页China Journal of Modern Medicine

基　　金：全军"十一五"计划专项课题(No:06Z017)

摘　　要：目的检测腹腔感染时SD大鼠肠道粪便中肠源性防御素-5(rat defensin-5,RD-5)的变化,探讨其对肠黏膜屏障功能监测的意义。方法 SD大鼠80只,随机分成实验组和对照组,每组40只。实验组采用腹腔注射脂多糖(LPS)制作腹腔感染模型,剂量0.01 g/kg,对照组仅注射同等剂量生理盐水。分别于造模后2、4、8、12和24 h取血、粪便和末端回肠组织,检测血清二胺氧化酶(DAO)水平及粪便中RD-5水平,光镜下观察各组末端回肠黏膜形态学改变并对其损伤予以分级,并行血DAO、粪便RD-5和末端回肠损伤病理评分的相关性分析。结果对照组不同时间点末端回肠黏膜结构完整,实验组末端回肠黏膜和黏膜下层间质水肿、血管充血,黏膜层可见中性粒细胞浸润,肠绒毛毛细血管充血,部分区域有黏膜上皮脱落,浆膜层可见炎性渗出。与对照组同时间点比较,实验组血DAO水平在2 h即有明显升高(P<0.05),随着感染加重,8、12和24 h逐渐升高(P<0.05),与末端回肠损伤病理评分呈正相关。粪便中RD-5水平在2 h升高(P<0.05),而在4 h后降低(P<0.05),与末端回肠损伤病理评分无明显相关性,8、12和24 h降低显著(P<0.05),与末端回肠损伤病理评分呈负相关。结论粪便中RD-5含量变化可作为反映肠黏膜屏障功能状况的一种特异性指标。【Objective】To investigate the value of fecal defensin-5 in supervising intestinal mucosa barri-er function in rats with abdominal infection.【Methods】 A total of 80 SD rats were randomly divided into two groups（n =40 each）： experimental group（intraperitoneal lipopolysaccharide）,control group.The rats were injected intraperitoneally with LPS（0.01 g/kg） or sterile saline.The levels of DAO in plasma and fecal RD-5 were measured and at 5 consecutive time points,2,4,8,12 and 24 h after modeling.The morphologic changes were observed and graded with microscopy.Analyze the correlation between the levels of DAO in plasma and fecal RD-5,the histopathological score of small intestinal mucosa membrane.【Results】 No ab-normal changes were observed with optical microscope in the small intestinal mucosa membrane of rats in the control group.In the experimental group,microscopic examination revealed interstitial edema,vascular en-gorgement and neutrophil infiltration in the small intestine mucosa membrane and the submucosa.Plasma lev-els of DAO were increased in rats with abdominal infection（P 0.05）,positively correlated to the small in-testinal mucosa membrane histopathological score.In contrast,8,12,and 24 h,fecal RD-5 level were de-ceased in rats with abdominal infection（P 0.05）,negatively correlated to the small intestinal mucosa mem-brane histopathological score.【Conclusion】Fecal RD-5 level may be a sensitive marker to reflect the intesti-nal mucosa barrier function.

关 键 词：腹腔感染 防御素-5 二胺氧化酶 脂多糖 肠黏膜屏障 

分 类 号：R639[医药卫生—外科学] R-332[医药卫生—临床医学]