细胞凋亡在严重烧伤大鼠肠粘膜屏障损伤中的作用  

The role of intestinal mucosa apoptosis in the pathogenesis of gut barrier damage in rats after severe burns

作　　者：袁建成[1] 李艳萍 秦孝健[1] 周立新[1] 肖光夏[1] 

机构地区：[1]第三军医大学附属西南医院烧伤研究所,重庆400038 [2]武汉市三院

出　　处：《中国危重病急救医学》1999年第12期715-717,共3页Chinese Critical Care Medicine

基　　金：全军"九五"指令性攻关课题资助

摘　　要：目的：研究烫伤后大鼠小肠粘膜细胞凋亡在肠粘膜屏障损伤中的作用。方法：Ｗｉｓｔａｒ大白鼠，致３０％Ⅲ度烫伤，随机分为正常对照组、烫伤不复苏组及烫伤复苏组。分别在伤后２、４、６、１２、２４ 小时活杀动物，取小肠的回盲部，运用原位凋亡检测试剂盒，光镜下观察小肠粘膜细胞凋亡变化，同时观察其病理形态变化。结果：①凋亡细胞以粘膜表皮细胞为主。②凋亡细胞的数量以伤后６～１２小时最多，分布于绒毛顶端，后延伸至绒毛中下部；伤后２４小时凋亡细胞数量明显减少，仍多于正常对照组。提示大鼠小肠粘膜细胞凋亡的高峰在伤后６～１２ 小时与肠源性细菌、内毒素易位的高峰一致。③不复苏组动物小肠凋亡细胞数量较复苏组多。结论：肠粘膜细胞凋亡致肠粘膜屏障功能损伤共同参与了肠源性感染的发病过程；烫伤后大鼠小肠粘膜细胞的凋亡可能与缺血、缺氧有关，氧自由在其中发挥了重要作用。Objective:To assess the potential role of intestinal mucosa apoptosis in the pathogenesis of gut barrier damage in rats after severe burns.Methods:Wistar rats sustained with 30% total body surface area Ⅲ degree burns were used in the present study,and randomly divided into three groups:burns with resuscitation,burns without resuscitation,and normal controls.Tissue samples were removed from ileum for apoptosis determination by in situ immunohistochemical staining at 2,4,6,12,and 24 hours postburn,and pathological changes were also observed under light microscopy.Results:Mucosal epithelieum appeared to be the major apoptotic cells,and number of the apoptotic cells increased after burns,peaking at 6 to 12 hours postburn.The apoptotic cells located at the tip of villus and gradually spread to whole villus.At 24 hours after burns,the number of apoptotic cells decreased,but they were still higher than those of normal controls.The maximal apoptosis occurred at 6 to 12 hours postburn,which was consistant with bacterial translocation in rats during the early phase of severe burns.Conclusions:It is suggested that the small intestinal mucosa apoptosis plays an important role in the pathogenesis of gut barrier damage,thereby leading to bacterial translocation from gastrointestinal tract.Small intestinal mucosa apoptosis induced by severe burns may be associated with local ischemia and hypoxia,and free radicals appears to be a major factor involved in the process of apoptosis.

关 键 词：烧伤 大鼠 肠源性感染 细胞凋亡 

分 类 号：R644.02[医药卫生—外科学]