肢体缺血预处理对大鼠肝门阻断开放时肠损伤的影响  

Effects of limb ischemic preconditioning on intestinal injury during release of hepatic portal occlusion in rats

作　　者：郑晓春[1] 涂文劭[1] 黄风怡[1] 李荣钢[1] 陈江湖[1] 孟彦平 

机构地区：[1]福建医科大学省立临床学院福建省立医院麻醉科,福州市350001 [2]新疆昌吉回族自治州中医院麻醉科

出　　处：《中华麻醉学杂志》2013年第10期1252-1255,共4页Chinese Journal of Anesthesiology

基　　金：福建省自然科学基金（2013J01116,2008J0265）;福建省卫生厅青年科研课题基金（2013-2-2）;福建省卫生厅医学创新基金（2009-CBX-3）

摘　　要：目的 评价肢体缺血预处理对大鼠肝门阻断开放时肠损伤的影响.方法 健康雄性SD大鼠36只,6～7周龄,体重200 ～ 250 g,采用随机数字表法,将其分为3组：假手术组（S组,n=12）、肝门阻断开放组（RHPO组,n=39）及肢体缺血预处理＋肝门阻断开放组（LIP＋ RHPO组,n=20）.采用Pringle法阻断全肝血流30 min后开放的方法制备肝门阻断开放模型,LIP＋ RHPO组阻断右侧后肢血流10 min时开放,开放24 h时行肝门阻开放处理.肝门开放6h时取小肠黏膜,光镜下观察病理学结果,进行Chiu评分,测定丙二醛（MDA）含量、超氧化物歧化酶（SOD）活性、髓过氧化物酶（MPO）活性、总抗氧化能力（T-AOC）和细胞间粘附分子（ICAM-1）的mRNA及其蛋白表达.结果 与S组比较,RHPO组肠黏膜Chiu评分、MDA和MPO水平升高,肠黏膜SOD活性及T-AOC降低,肠黏膜ICAM-1的mRNA及其蛋白表达上调（P＜0.05或0.01）;与RHPO组比较,LIP＋ RHPO组肠黏膜Chiu评分、MDA和MPO水平降低,肠黏膜SOD活性及T-AOC升高,肠黏膜ICAM-1 mRNA下调（P＜0.05）.结论 肢体缺血预处理可减轻大鼠肝门阻断开放时肠损伤,其机制与增强抗氧化能力及下调ICAM-1表达有关.Objective To evaluate the effects of limb ischemic preconditioning （LIP） on the intestinal injury during release of hepatic portal occlusion （RHPO） in rats.Methods Thirty-six male Sprague-Dawley rats,aged 6-7 weeks,weighing 200-250 g,were randomly divided into 3 groups using a random number table：sham operation group （group S,n =12）,RHPO group （n =39） and LIP＋ RHPO group （n =20）.Hepatic ischemia/ reperfusion was produced by occluding portal vein and hepatic artery for 30 min followed by 6 h reperfusion according to Pringle＇s method.LIP was produced by tourniquet occlusion of the right femoral artery and vein for 10 min followed by 24 h reperfusion before hepatic ischemia.The animals were sacrificed at 6 h after hepatic portal occlusion was released and the mucous membrane of small intestine was obtained for microscopic examination and for determination of malondialdehyde （MDA） content,superoxide dismutase （SOD） activity,myeloperoxidase （MPO）activity,total antioxidant capacity （T-AOC） and intercellular adhesion molecule-1 （ICAM-1） mRNA and protein expression.The degree of damage to intestinal mucous membrane was scored according to Chiu.Results Compared with group S,Chiu＇s score and levels of MDA and MPO were significantly increased,SOD activity and TAOC were decreased,and ICAM-1 mRNA and protein expression was up-regulated in group RHPO （P ＜ 0.05 or 0.01）.Compared with group RHPO,Chiu＇s score and levels of MDA and MPO were significantly decreased,SOD activity and T-AOC were increased,and ICAM-1 mRNA expression was down-regulated in group LIP ＋ RHPO （P ＜ 0.05）.Conclusion LIP can alleviate the intestinal injury during RHPO in rats by enhancing the antioxidant function and down-regulating the expression of ICAM-1.

关 键 词：缺血预处理 后肢 肝 再灌注损伤 肠黏膜 

分 类 号：R614[医药卫生—麻醉学]