β受体阻滞剂对术后肠麻痹模型大鼠胃肠动力及炎性反应的影响  

Effect ofβ-adrenoceptor blockade on gastrointestinal motility and intestinal inflammation in the rat model of postoperative ileus

作　　者：谈善军[1] 庄秋林[1] 奚秋磊[1] 孟庆洋[1] 蒋奕[1] 吴国豪[1] Tan Shanjun;Zhuang Qiulin;Xi Qiulei;Meng Qingyang;Jiang Yi;Wu Guohao(Department of General Surgery,Shanghai Clinical Nutrition Research Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院普通外科上海市临床营养研究中心,200032

出　　处：《中华实验外科杂志》2020年第5期860-863,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金(81900484);中国博士后科学基金资助项目(2019M661370);上海市青年科技英才扬帆计划(18YF1404700);上海市自然科学基金(19ZR1409100);上海市卫生健康系统重要薄弱学科建设计划-临床营养学(2019ZB0105);复旦大学附属中山医院青年科学基金(2016ZSQN56)。

摘　　要：目的:观察β受体阻滞剂对术后肠麻痹(POI)模型大鼠胃肠动力及炎性反应的影响。方法:将24只SD大鼠(购自上海西普尔-必凯实验动物有限公司)随机分为3组:对照组、POI组和β受体阻滞剂组,每组8只。POI组和β受体阻滞剂组大鼠开腹后暴露腹腔,但不进行任何手术操作,暴露3 h后关腹,建立POI模型;对照组大鼠仅作麻醉处理。β受体阻滞剂组大鼠分别于术前2 h和术后12 h给予5 mg/kg的酒石酸美托洛尔灌胃;对照组和POI组大鼠在相同条件下分别给予等量的生理盐水灌胃。实验过程中监测大鼠的心率变化,并在术后24 h进行炭末推进实验后取小肠组织标本,检测肠道肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β和IL-6浓度以及髓过氧化物酶(MPO)活性。多组间比较采用单因素方差分析,两组间比较采用 t检验。 结果:术前2 h对照组、POI组和β受体阻滞剂组大鼠心率分别为(335±18)、(341±19)、(338±17)次/分,3组间比较差异无统计学意义( F=0.208, P>0.05);手术开始、术后6 h、术后12 h、术后24 h POI组大鼠心率明显高于对照组[(328±17)次/分比(303±15)次/分、(379±21)次/分比(337±17)次/分、(389±21)次/分比(331±19)次/分、(397±21)次/分比(333±16)次/分, t=2.728、3.838、4.887、5.861, P<0.05],但β受体阻滞剂组心率在各时间点均低于POI组,且在术后6 h、术后12 h、术后24 h差异有统计学意义[(351±18)次/分比(379±21)次/分、(359±18)次/分比(389±21)次/分、(365±20)次/分比(397±21)次/分, t=2.542、2.617、2.664, P<0.05]。对照组、POI组和β受体阻滞剂组大鼠炭末推进率分别为(65.13±7.06)%、(41.20±4.64)%、(54.04±6.29)%,POI组和β受体阻滞剂组明显低于对照组( t=6.939、2.874, P<0.05),β受体阻滞剂组明显高于POI组( t=4.020, P<0.05)。POI组较对照组大鼠肠道炎性因子浓度明显升高[TNF-α:(182.13±17.45) pg/g比(98.35±10.98) pg/g、IL-1β:(66.27±4.88) pg/g比(52.33±4.49) pg/g�Objective To investigate the effect ofβ-adrenoceptor blockade metoprolol on gastrointestinal motility and intestinal inflammation in the rat model of postoperative ileus(POI).Methods Twenty four rats were randomized into three groups:control group,POI group andβ-adrenoceptor blockade group,respectively(n=8 each).Rats in POI andβ-adrenoceptor blockade groups underwent laparotomy without any operative procedures but for peritoneal air exposure for three hours to induce the model of POI.The animal in control group only received the same anesthesia.Rats inβ-adrenoceptor blockade group received metoprolol tartrate(5 mg/kg)via gavage at 2 hours before surgery,and at 12 hours after surgery,respectively.The animal in control and POI groups received an equal volume of saline at the same time points and by the same method asβ-adrenoceptor blockade group.During the experiment period,the heart rate was monitored,and at 24 h after surgery,gastrointestinal transit was assessed by charcoal transport,and then intestinal samples were obtained to assess concentrations oftumour necrosis factor(TNF)-α,interleukin(IL)-1βand IL-6,and the activity of myeloperoxidase(MPO).Data were analyzed using one-way analysis of variance for multigroup comparisons or using theindependent-samples t test for two group comparisons.Results The heart rate at 2 h before surgeryin control group,POI group andβ-adrenoceptor blockade group was(335±18),(341±19),(338±17)beat/min respectively,and there was no significant difference in the heart rate between three groups(F=0.208,P>0.05),and the heart rate in POI group was significantly higher than that in control group at the start of surgery,6 h after surgery,12 h after surgery,and 24 h after surgery[(328±17)beat/min vs.(303±15)beat/min,(379±21)beat/min vs.(337±17)beat/min,(389±21)beat/min vs.(331±19)beat/min,(397±21)beat/min vs.(333±16)beat/min,t=2.728,3.838,4.887,5.861,P<0.05].However,the heart rate inβ-adrenoceptor blockade group was lower than that in POI group at all time points,and diff

关 键 词：术后肠麻痹 胃肠动力 炎症 Β受体阻滞剂 腹部手术 

分 类 号：R-332[医药卫生] R61