右美托咪定不同用药方式减轻大鼠腹腔粘连  

Effect of different administrations of dexmetomidine on abdominal adhesion in rats

作　　者：张梦婕 冷玉芳[1,2] 马莉[1] 孟宁 Zhang Meng-jie;Leng Yu-fang;Ma Li;Meng Ning(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Department of Anesthesiology,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医医院,甘肃兰州730000 [2]兰州大学第一医院麻醉科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2021年第1期22-27,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃卫生行业科研计划项目(GSWSKY2017-18);国家自然科学基金资助项目(81960345)。

摘　　要：目的探讨局部腹腔应用右美托咪定抗大鼠腹腔粘连的作用及血清转化生长因子-β1(TGF-β1)对腹腔粘连的意义。方法40只大鼠采用随机数字表法分为4组(n=10):假手术(Sham)组、粘连模型(M)组、右美托咪定静脉注射(DEX-V)组、右美托咪定腹腔注射(DEX-P)组。M、DEX-V、DEX-P组大鼠通过盲肠摩擦法建立腹腔粘连模型,Sham组大鼠仅打开腹腔后缝合,M组大鼠经腹腔和尾静脉同时注射生理盐水2 mL,DEX-P组大鼠于腹腔内给予右美托咪定(10μg/kg)2 mL,并在尾静脉注射生理盐水2 mL;DEX-V组大鼠尾静脉注射右美托咪定(10μg/kg)2 mL,并在腹腔注入生理盐水2 mL;于建模7 d后处死大鼠,取大鼠血清及腹水用ELISA法检测大鼠血清肿瘤坏死因子-α(TNF-α)、TGF-β1质量浓度及腹水中TGF-β1质量浓度;取各组大鼠盲肠造模部位壁层腹膜、盲肠及粘连组织,在光学显微镜下观察腹膜及盲肠组织中性粒细胞浸润情况和胶原纤维增生程度。结果与Sham组大鼠比较,M、DEX-V、DEX-P组大鼠腹水TGF-β1质量浓度均升高(P<0.05),M组大鼠血清TGF-β1质量浓度升高(P<0.01),M、DEX-V组大鼠血清TNF-α质量浓度均升高(P<0.05),并出现腹腔粘连,腹膜及盲肠组织出现不同程度中性粒细胞浸润,胶原纤维增生显著;与M组大鼠比较,DEX-V、DEX-P组大鼠经右美托咪定处理后,血清TNF-α、TGF-β1及腹水TGF-β1质量浓度均显著降低(P<0.05),腹膜、盲肠组织中性粒细胞浸润减少,胶原纤维组织增生不显著;与DEX-P组大鼠比较,DEX-V组大鼠血清TNF-α及腹水TGF-β1质量浓度均升高(P<0.05),局部腹膜组织、盲肠组织中性粒细胞浸润增多,胶原纤维组织显著增生。结论右美托咪定腹腔局部应用可有效减轻大鼠腹腔炎症反应,并且显著减轻腹腔粘连,且其抗炎及抗粘连效果均优于静脉注射,其抗粘连机制与右美托咪定通过降低炎症反应后减轻腹腔粘连形成有关。血清TGF-β1质量浓度变化�Objective To investigate the effect of local intraperitoneal administration of dexmedetomidine on abdominal adhesion in rats and the significance of serum transforming growth factor-β1(TGF-β1)on abdominal adhesion.Methods Forty rats were randomly divided into 4 groups(n=10):a Sham operation (Sham) group, model (M) group, dexmetomidine intravenous injection (DEX-V) group and dexmetomidineintraperitoneal administration (DEX-P) group. The abdominal adhesion model was established by cecal frictionin M, DEX-V and DEX-P group, only after a abdominal cavity was opened and sutured in Sham group,and saline 2 mL was injected into the abdominal cavity and caudal vein in M group at the same time. InDEX-P group, dexmetomidine (10 μg/kg) 2 mL was given intraperitoneally and injected into the caudal vein.The rats in DEX-V group were injected with dexmetomidine (10 μg/kg) 2 mL intravenously and intraperitoneallywith normal saline 2 mL, the rats were killed 7 days after modeling. The concentrations of tumornecrosis factor-α (TNF-α) and TGF-β1 in serum and ascites and the concentration of TGF-β1 in ascites weremeasured by the ELISA method, the parietal peritoneum, cecum and adhesive tissue of cecum in each groupwere taken. The infiltration of neutrophils and the degree of collagen fiber proliferation in peritoneum andcecum were observed under a light microscope. Results Compared with the Sham group, the concentrationof TGF- β1 in ascites of M, DEX-V and DEX-P group increased (P < 0.05), in M group the concentrationof serum TGF-β1 increased (P < 0.01). The levels of serum TNF-α in M and DEX-V group were significantlyhigher than those in Sham group (P < 0.05), abdominal adhesion occurred in both groups. Neutrophils infiltratedand collagen fibers proliferated significantly in peritoneum and cecum compared with M group,DEX-V and DEX-P group were treated with dexmetomidine. The concentrations of TNF-α, TGF-β1 in serumand TGF- β1 in ascites were significantly decreased, neutrophil infiltration in peritoneum and cecum wasde

关 键 词：右美托咪定 腹腔粘连 转化生长因子-Β1 

分 类 号：R619[医药卫生—外科学]