手术松解时机对梗阻小肠黏膜紧密连接的影响  

Effect of surgical adhesiolysis opportunity on intestinal epithelial tight junction in experimental small bowel obstruction

作　　者：高志刚[1] 陈爱霞[1] 邢敬龙[1] 马晓娟[1] 刘彤[1] 

机构地区：[1]天津医科大学基础医学院外科手术学教研室,300070

出　　处：《中华实验外科杂志》2012年第10期2025-2027,共3页Chinese Journal of Experimental Surgery

摘　　要：目的观察犬梗阻小肠黏膜紧密连接的变化和Claudin2的表达，探讨手术松解时机对紧密连接修复的影响。方法40条犬制作低位小肠梗阻模型，随机分为对照组、肠梗阻72、120h组和以上2时相点的手术松解组，透射电镜观察各组小肠黏膜紧密连接变化，免疫组织化学方法观察黏膜Claudin2表达。结果肠梗阻72h梗阻近段黏膜紧密连接缩短、模糊，Claudin2相对吸光度值（32．83），较对照组（94．84）表达下调（P〈0．01），松解梗阻后紧密连接修复，Claudin2（46．67）较梗阻72h组表达上调（P〈0．01）。肠梗阻120h紧密连接消失，松解梗阻后未见修复，Claudin2（7．33～9．63）较梗阻120h组（6．37～7．83）表达未见上调。结论肠梗阻致黏膜紧密连接破坏的严重程度与肠梗阻时间相关，肠梗阻120h后肠黏膜紧密连接的损伤不可修复，肠梗阻的早期诊断和积极治疗非常重要。Objective To observe tight junction （TJ） of intestinal epithelial and expression of Claudin2 after small bowel obstruction in dogs, and investigate the effect of surgical adhesiolysis opportunity on the repair of TJ. Methods Forty dogs were divided into 72-h obstruction group, 120-h obstruction group, 72-h adhesiolysis group, 120-adhesiolysis group and control group. Models of mechanical bowel obstruction at the ileum were made in each test group. At definite time point samples of intestinal mucosa were obtained and examined under the transmission electron microscopy. The expression of elaudin2 in the intestinal mucosa was detected by using immunohistochemistry. Results At 72nd h after bowel obstruction, it was .found TJ was shortened and dim, and the expression of claudin2 （relative absorbance = 32. 83 ） was down-regulated as compared with 94. 84 in control group （ P 〈 0.01 ）. At 120 h after adhesiol- ysis, TJ was repaired, and the expression of clandin 2 （46. 67 ） was up-regulated as compared with 72-h obstruction group. At 120 h after obstruction, TJ disappeared, and no repair was found after adhesiolysis. The expression of claudin2 （6. 37-7.83 ） was also down-regulated obviously. In 120-h adhesiolysis group, there was no repair in TJ, and there was slight up-regulated expression of claudin2 （7.33-9. 67 ） as compared with 120-h obstruction group. Conclusion Bowl obstruction damaged TJ of intestinal mucosa, and resulted in down-regulated expression of claudin2. The severity of the injury was related with the duration of obstruction. 120 h after bowel obstruction, TJ injury can＇ t be repaired by surgical adhesiolysis.

关 键 词：松解 肠梗阻 肠黏膜 紧密连接 

分 类 号：R285.5[医药卫生—中药学]