血清平滑肌蛋白22诊断急性缺血性肠病的实验研究  

Experimental study of serum SM22 in the diagnosis of acute intestinal ischemia

作　　者：李海坤[1] 王敏华 周小青 殷青辉 叶斌 曾祥福[1] 刘晓平[1] 朱贤森[3] 曾祥泰[1] Li Haikun;Wang Minhua;Zhou Xiaoqing;Yin Qinghui;Ye Bin;Zeng Xiangfu;Liu Xiaoping;Zhu Xiansen;Zeng Xiangtai(Department of Gastro-intestinal Surgery,The First Hospital of Gan-Nan Medical University,Ganzhou 341000,China;Department of General surgery,The Second Hospital of Gan-Nan Medical University,Ganzhou 341000,China;The Pathology Teaching and Research Section,Gan-Nan Medical University,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院胃肠外科,江西省赣州341000 [2]赣南医学院第二附属医院普外科,江西省赣州341000 [3]赣南医学院病理学教研室,江西省赣州341000

出　　处：《中华普通外科杂志》2019年第2期151-153,共3页Chinese Journal of General Surgery

摘　　要：目的探讨血清平滑肌蛋白22(SM22)在急性缺血性肠病诊断中的意义。方法选取健康成年SD大鼠96只,分为实验组和对照组,每组48只,两组内再分成6小组,每组8只。实验组结扎肠系膜上动脉,对照组仅行腹腔开关术。分别在手术后0.5、1、2、4、8、12h从右心室中抽取静脉血,用ELISA法检测SM22浓度。处死大鼠,在回盲部近端切取长约10cm小肠组织,行HE染色和直接免疫荧光染色法标记肠组织中SM22。结果肠组织缺血4h时血清SM22浓度开始升高,并且达到峰值(265±15)ng/L。随着缺血时间的延长SM22浓度逐渐下降,与对照组相比差异具有统计学意义(P<0.05)。肠组织缺血4h内,光镜下SM22阳性颗粒数无明显变化;缺血4h后,光镜下SM22阳性颗粒数逐渐下降,各实验组与对照组相比差异均有统计学意义(均P<0.05)。结论SM22主要表达在肠平滑肌层,当肠组织受缺血损伤致肠肌层坏死时,SM22从肠肌层漏出并入血使血清中SM22浓度升高。血清SM22可用于判断肠组织缺血坏死。Objective To evaluate smooth muscle protein of 22 kDa (SM22) in the diagnosis of acute intestinal ischemia. Methods 96 healthy adult SD rats were evenly divided into experimental group and control group,with each group subdivided into 6 subgroups,subject respectively to superior mesenteric artery ligation or sham operation.The venous blood samples were extracted from each group rats′ right heart at 0.5,1,2,4,8,12 h after the operation,for SM22 testing and small intestines tissues for direct immunofluorescence staining of SM22. Results The serum SM22 concentration reached a peak at 4 h(265±15)mg/L,then gradually decreased (P<0.05).The I-FABP was mainly expressed in the epithelium of intestinal mucosa.During the 4 hours of intestinal ischemia,The number of SM22 positive particles did not change.After 4 hours,the number of SM22 positive granules had gradually decreased compared with the control group (all P<0.05). Conclusion SM22 mainly exists in the smooth muscle of intestinal,during the ischemic necrosis of the intestinal muscle layer SM22 leaks into blood stream,resulting in high serum levels of SM22 facilitating early diagnosis of acute intestinal ischemia.

关 键 词：缺血 诊断 平滑肌蛋白22 

分 类 号：R574[医药卫生—消化系统]