小剂量氯胺酮预处理对大鼠气腹所致小肠缺血再灌注损伤的保护作用  

Protective effect of low- dose ketamine against intestinal ischemia- reperfusion injury following carbon dioxide pneumoperitoneum in rats

作　　者：王伟[1] 田福宏[2] 严六狮[1] 

机构地区：[1]西安交通大学医学院第一附属医院麻醉科,陕西西安710061 [2]陕西韩城矿务局总医院麻醉科,陕西韩城715400

出　　处：《南方医科大学学报》2013年第11期1685-1688,共4页Journal of Southern Medical University

基　　金：陕西省科技攻关项目(2012K16-04-02)

摘　　要：目的探讨小剂量氯胺酮预处理对大鼠气腹所致小肠缺血再灌注损伤的保护作用。方法 30只健康无特殊病原体级雄性SD大鼠随机分为3组,每组10只。sham组(假手术组,S组,n=10):本组大鼠插管接CO2气腹机,但不充气。model组(模型组,M组,n=10):插管并充气120 min后放气。ketamine组:(氯胺酮预处理组,K组,n=10):气腹前10 min腹腔注射氯胺酮10 mg/kg,插管并充气120 min后放气。同时S组和M组注射等容量的生理盐水。气腹结束后15 min切取小肠组织测定丙二醛(MDA)含量并行病理分析;同时检测血清中肠型脂肪酸结合蛋白(I-FABP)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子α(TNF-α)含量。结果 S组的小肠组织MDA含量明显低于其它两组(P<0.05);且K组肠组织中的MDA含量低于M组大鼠(P<0.05)。与S组相比,K组、M组大鼠血淸I-FABP、IL-6、IL-8、TNF-α含量明显升高(P<0.05);K组明显低于M组(P<0.05)。S组为正常的小肠切片表现;在其他两组小肠黏膜均有不同程度的损伤,病变以M组中最为严重,绒毛结构完整性稍差,排列稍乱,见较多的炎症细胞,粘膜可见充血明显;K组肠黏膜损伤较M组减轻,表现为绒毛顶部脱落减少,少量中性粒细胞浸润。结论小剂量氯胺酮预处理可减轻脂质过氧化反应和抑制促炎性因子释放,对于腹腔镜下气腹所致小肠缺血再灌注损伤有一定的保护作用。Objective To investigate the protective effect of low-dose ketamine against intestinal ischemia reperfusion injury following pneumoperitoneum with carbon dioxide in rats. Methods Thirty healthy male adult SD rats （body weight 280-320 g） were randomized into sham-operated group, model group and ketamine group and subjected to pneumoperitoneum for 120 min with carbon dioxide （not in sham-operated group）. The rats in ketamine group received an intraperitoneal injection of 10 mg/kg ketamine 10 min before pneumoperitoneum, and those in the other two groups received saline injection. Fifteen minutes after pneumoperitoneum or sham operation, the small intestines were sampled to detect the content of malondialdehyde （MDA） and fore pathological testing. ELISA was used to detect the serum levels of I-FABP, TNF-a IL-6 and IL-8. Results Pneumoperitoneum caused a sig^ficant increase in intestinal MDA content （P〈0.05）, which was lowered by ketamine pretreatment （P〈0.05）. Serum I-FABP, TNF-a, IL-6 and IL-8 levels all significantly increased following pneumoperitoneum （P〈0.05） and were obviously lowered by ketamine pretreatment （P〈0.05）. Pneumoperitoneum also caused obvious pathologies in intestinal mucosa, which were ameliorated by ketamine pretreatment. Conclusion Low-dose ketamine preconditioning can reduce the inflammatory reaction and lessen oxidative damage in the intestinal mucosa following pneumoperitoneum in rats.

关 键 词：小剂量氯胺酮预处理 气腹 小肠 缺血再灌注损伤 

分 类 号：R965[医药卫生—药理学]