根皮素联合透明质酸钠抑制大鼠模型术后腹腔粘连形成及其机制研究  

Phloretin combined with sodium hyaluronate inhibits formation of postoperative abdominal adhesions in a rat model and its mechanism

作　　者：张志星 龙延滨[2] 宋斌[2] 聂灵芝 吴云桦 都庆国[2] ZHANG Zhixing;LONG Yanbin;SONG Bin;NIE Lingzhi;WU Yunhua;DU Qingguo(Yan’an University School of Medicine,Yan’an,Shaanxi 716000,P.R.China;Department of General Surgery,Shaanxi Provincial People’s Hospital,Xi’an 710061,P.R.China)

机构地区：[1]延安大学医学院,陕西延安716000 [2]陕西省人民医院普通外科,西安710061

出　　处：《中国普外基础与临床杂志》2023年第11期1323-1328,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：陕西省自然科学基础研究计划项目(项目编号:2022JQ-763)。

摘　　要：目的探究根皮素联合透明质酸钠预防大鼠术后腹腔粘连形成的效果及其可能的机制。方法将40只大鼠随机分为5组,假手术组大鼠只行开关腹手术,其余4组行盲肠搔刮摩擦法造模成功后接受不同处理:对照组及根皮素组(PHL组)大鼠造模后关腹,透明质酸钠组(HA组)及根皮素联合透明质酸钠组(PHL+HA组)大鼠采用2 mL透明质酸钠凝胶涂抹受损腹壁及盲肠后关腹;术后使用根皮素治疗的组别(PHL组和PHL+HA组)每日予以2 mL由0.5%羧甲基纤维素钠溶解的40 mg/kg根皮素灌胃治疗,其余组别均予以0.5%羧甲基纤维素钠溶液2 mL灌胃。术后第7天全身麻醉后处死大鼠,采用Nair’s评分评估术后第7天大鼠的粘连情况;并收集粘连组织或者正常腹膜组织(假手术组收集盲肠及其对面的腹膜组织),行免疫组织化学染色评估Nrf2抗体染色程度,行HE染色评估炎症评分,行天狼星红染色评估胶原组织厚度,并检测转化生长因子β1(transforming growth factorβ1,TGF-β1)、丙二醛(malondialdehyde,MDA)和超氧化物歧化酶(superoxide dismutase,SOD)水平。结果所有大鼠均顺利完成实验,与对照组相比较,PHL+HA组的Nair’s评分、炎症评分、TGF-β1的表达水平、胶原组织厚度、MDA水平降低(P<0.05),SOD活性和Nrf2的表达水平升高(P<0.05)。结论根皮素联合透明质酸钠可预防大鼠模型中术后腹腔粘连形成,这可能与降低炎症反应、减轻胶原沉积、激活Nrf2通路进而抑制氧化应激反应有关。Objective To investigate the efficacy of phloretin combined with sodium hyaluronate in preventing postoperative abdominal adhesion formation in rats and its possible mechanisms.Methods Forty rats were randomly divided into five groups,the rats in the sham-operatinon group only underwent open and closed abdominal surgery,and the remaining rats of four groups underwent cecum scratch-and-rub method of modeling to receive different treatments:the rats in the control group and the phloretin group(PHL group)were closed abdominally after modeling,while the rats in the sodium hyaluronate group(HA group)and the phloretin combined with sodium hyaluronate group(PHL+HA group)were closed abdominally by using 2 mL of sodium hyaluronate gel coated with the damaged abdominal wall and the cecum;the postoperative groups treated with phloretin(the PHL and PHL+HA groups)were treated with 2 mL of 40 mg/kg phloretin dissolved in 0.5%sodium carboxymethylcellulose by gavage daily,and the rest of the groups were treated with 2 mL of 0.5%sodium carboxymethylcellulose solution by gavage.After general anesthesia,the rats were executed on the 7th day after surgery,and the Nair’s score was used to evaluate the adhesion status of each group on the 7th day after surgery;the adhesive tissue or normal peritoneal tissue were collected(cecum and its opposite side of the peritoneal tissue was collected in the sham-operation group),and immunohistochemistry was performed to evaluate the degree of staining with Nrf2 antibody,HE staining was performed to evaluate the inflammation scores,and Sirius red staining was performed to evaluate the thickness of the collagen fibers,and levels of transforming growth factorβ1(TGF-β1),malondialdehyde(MDA)and superoxide dismutase(SOD)were measured.Results All rats successfully completed the experiment.Compared with the control group,Nair’s score,inflammation score,expression level of TGF-β1,thickness of collagen fibers in the adherent tissues,and MDA level were significantly lower in the PHL+HA group(P<0.05),b

关 键 词：术后腹腔粘连 根皮素 氧化应激反应 Nrf2通路 

分 类 号：R656[医药卫生—外科学] R-332[医药卫生—临床医学]