丙酮酸乙酯对脓毒症大鼠小肠黏膜屏障的保护作用及其机制  

Protective effect and mechanism of ethyl pyruvate on the small intestine barrier in rats with sepsis

作　　者：张庆伟 王春亭[2] 王启志[2] 张琳[2] 王鹏[2] 孟玫[2] 

机构地区：[1]山东医学高等专科学校,山东济南250002 [2]山东大学附属省立医院重症医学科,山东济南250021

出　　处：《山东大学学报（医学版）》2014年第5期30-34,共5页Journal of Shandong University:Health Sciences

摘　　要：目的探讨丙酮酸乙酯(EP)对脓毒症大鼠小肠黏膜屏障功能的影响及其机制。方法采用盲肠结扎穿孔术(CLP)将85只Wistar大鼠制备脓毒症模型,并随机分成脓毒症林格氏液组(Rin组)、脓毒症EP治疗组(EP组)、假手术对照组。观察各组大鼠小肠黏膜组织变化和细菌移位情况,检测小肠黏膜微循环血流量和髓过氧化物酶的活性变化,以及诱生型一氧化氮合酶(iNOS)mRNA表达水平和肠腔内的肥大细胞蛋白酶(RMCPⅡ)量的变化,统计各组大鼠的96 h生存率。结果 Rin组小肠黏膜损伤较重,EP组小肠黏膜较Rin组有改善,细菌移位集落数减少;假手术对照组未发现细菌移位;与假手术对照组比较,Rin组小肠黏膜的血流减少(P<0.001),MPO表达增高(P<0.001),RMCPⅡ浓度增高显著(P<0.001),iNOS/β-actin比值升高(P<0.001);与Rin组比较,EP组腹腔注射EP后能改善小肠黏膜微循环血流量(P<0.001),抑制MPO(P<0.05)和iNOS高表达(P<0.05),对RM CPⅡ影响不大(P>0.05),可提高脓毒症大鼠的96 h生存率(P<0.01)。结论 EP可能是通过减少肠道组织M PO、iNOS表达,降低脓毒症大鼠肠道黏膜细菌移位,显著改善微循环血流,对脓毒症大鼠的小肠黏膜屏障有一定的保护作用。Objective To explore the effects of ethyl pyruvate（EP） on the small intestine barrier in rats with sepsis and its possible mechanism. Methods A total of 85 Wistar rats with sepsis induced by cecal ligation and puncture surgery（CLP） were randomly divided into 3 groups： Ringer’s administration group（Rin group）,the septic group with ethyl pyruvate administration（EP group） and sham-operated group（the control group）. The histological changes and bacterial translocation in the ileal architecture microvascular were observed,perfusion of small intestine,activity of myeloperoxidase（MPO）,the level of inducible nitric oxide synthase（iNOS） mRNA and rat mast cell protease-Ⅱ（RMCP Ⅱ） were tested,and the survival rate of rats was calculated. Results The Rin group had more severe injury of small intestinal mucosa,while the EP group had better morphological changes,and fewer bacterial colonies shift compared with the Rin group. Compared with the control group,the Rin group had weaker blood flow,higher expression of MPO,RMCP Ⅱ,and iNOS（all P ＆lt; 0. 001）. Compared with the Rin group,EP group had enlarged blood flow,decreased expressions of M PO and iNOS,and higher survival rate of animals（all P ＆lt; 0. 001）. Conclusion EP can ameliorate the morality rate of sepsis and improve the microcirculation by decreasing M PO and iNOS expressions in the small intestine,which may protect the small intestine barrier of septic rats.

关 键 词：脓毒症 丙酮酸乙酯 小肠黏膜屏障 Wistar 大鼠 

分 类 号：R631.4[医药卫生—外科学]