淋巴引流及ω-3多不饱和脂肪酸干预对大鼠肠道缺血再灌注的影响  

Effects of lymphatic drainage and ω-3 polyunsaturated fatty acids on intestinal ischemia-reperfusion injury in rats

作　　者：周开国[1] 何桂珍[1] 张睿[1] 陈雪峰[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院肠内肠外营养科,100730

出　　处：《中华医学杂志》2011年第25期1775-1779,共5页National Medical Journal of China

基　　金：基金项目：国家自然科学基金（30940069）;北京市自然科学基金（7102127）

摘　　要：目的观察大鼠肠道缺血再灌注（I／R）损伤时肠淋巴液引流对高迁移率族蛋白1（HMGB1）、炎症因子和内毒素的影响以及ω-3多不饱和脂肪酸（ω-3PUFA）干预的效果。方法72只SD大鼠随机区组法随机分为单纯引流组、I／R组、I／R＋引流组（每组8只）和胃造口组[正常饮食（N）组、普通肠内营养（EN）组、普通肠内营养加ω-3PUFA（PUFA）3大组，每大组再根据是否行I／R和引流分为2组，每组8只]。单纯引流组只引流180min淋巴液不行I／R损伤；I／R、I／R＋引流组行肠系膜上动脉夹闭60min再灌注120min；I／R＋引流组同时行肠淋巴液引流180min。胃造口组大鼠均先行胃造口手术，分别给予不同营养5d后造模，各引流组同前进行肠淋巴液引流180min。手术完毕后分别取血清和淋巴液，定量检测内毒素，酶联免疫吸附试验（ELISA）定量检测炎症因子以及HMGBl。结果I／R＋引流组淋巴液中内毒素、炎症因子以及HMGBl均高于单纯引流组[均P〈0．05，白细胞介素（IL）_6（30±8）pg／ml比（20±6）pg／ml，内毒素（0．029±0．011）U／ml比（0．008±0．005）U／ml]；I／R＋引流组血清中内毒素、炎症因子均低于I／R组（均P〈0．05）。在胃造口组中，N组和EN组的淋巴液中肿瘤坏死因子（TNF-α与HMGBl均高于PUFA组[（46±17）pg／ml、（54±16）pg／ml比（28±9）pg／ml，（4．8±1．6）ng／ml、（5．34-1．8）ng／ml比（3．0±1．0）ng／ml，均P〈0．05]。PUFA（I／R）组血清中内毒素、炎症因子以及HMGBl均低于N（I／R）组（均P〈0．05），PUFA（I／R＋引流）组血清中TNF-α与HMGBl均低于N（I／R＋引流）组（均P〈0．05）。结论引流肠淋巴液能够降低肠道I／R损伤时内毒素、炎症因子和HMGB1的水平，减轻大鼠肠道I／R引起的损伤。ω-3PUFA的干预对于肠道I／R引起的损伤有一定的保护作用，对于减轻炎症反应有积极作用�Objective To investigate the effects of lymphatic drainage and ω-3 polyunsaturated fatty acid （ω-3PUFA） on high mobility group box 1 （HMGB1）, inflammatory cytokines and endotoxin in rats with intestinal ischemia-reperfusion （I/R） injury. Methods A total of 72 SD rats were randomly divided into drainage-alone group, I/R group, ischemia-reperfusion plus drainage （ I/R ＋ D） group （ n = 8 each） and 3 groups with 16 rats undergoing gastrostomy in each group： normal diet （N） group, enteral nutrition （EN） group and enteral nutrition ＆ ω-3PUFA （PUFA） group. And they were further divided into 2 sub- groups （n =8）. The rats in I/R and I/R ＋ D groups were subjected to a 60-min ischemia follow by 120-min reperfusion injury of superior mesenteric artery. When the rats suffered I/R injury, intestinal lymph was drained for 180 min in the I/R ＋ D group. The rats in the drainage-alone group received 180-min lymph drainage without I/R injury. After 5 days with different nutrition regimes, the models were established similarly. The rats in the I/R ＋ D sub-groups were treated with intestinal lymph drainage for 180 min. The serum and lymph samples were collected post-operatively. Endotoxin was detected by a Limulus kit. The inflammatory cytokines and high mobility group box 1 （HMGB1） were analyzed by enzyme-linkedimmunosorbent assay （ELISA）. Results Endotoxin, inflammatory cytokines and lymphatic HMGB1 of lymphatic in the I/R ＋ D group were higher than those in the drainage-alone group [ all P 〈 0. 05, IL-6 ： （30 ± 8 ） pg/ml vs （20± 6） pg/ml, endotoxin ： （0. 029± 0. 011 ） U/ml vs （0. 008 ± 0. 005 ） U/ml ]. The serum levels of endotoxin and inflammatory cytokines in the I/R ＋ D group were lower than those in the I/R group （P 〈0. 05）. The lymphatic levels of TNF-α（tumor necrosis factor-alpha） and HMGB1 in the N and EN groups were higher than those in the PUFA group [ TNF-α （46± 17） pg/ml, （54 ± 16） pg/ml vs （28± 9 ） pg/ml

关 键 词：再灌注损伤 高迁移率族蛋白质类 脂肪酸类 不饱和 淋巴引流 

分 类 号：R363[医药卫生—病理学]