中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
25期
1775-1779
,共5页
周开国%何桂珍%张睿%陈雪峰
週開國%何桂珍%張睿%陳雪峰
주개국%하계진%장예%진설봉
再灌注损伤%高迁移率族蛋白质类%脂肪酸类,不饱和%淋巴引流
再灌註損傷%高遷移率族蛋白質類%脂肪痠類,不飽和%淋巴引流
재관주손상%고천이솔족단백질류%지방산류,불포화%림파인류
Reperfusion injury%High mobility group proteins%Fatty acids,unsaturated%Lymphatic drainage
目的 观察大鼠肠道缺血再灌注(Ⅰ/R)损伤时肠淋巴液引流对高迁移率族蛋白1(HMGB1)、炎症因子和内毒素的影响以及ω-3多不饱和脂肪酸(ω-3 PUFA)干预的效果.方法 72只SD大鼠随机区组法随机分为单纯引流组、Ⅰ/R组、Ⅰ/R+引流组(每组8只)和胃造口组[正常饮食(N)组、普通肠内营养(EN)组、普通肠内营养加ω-3 PUFA(PUFA)3大组,每大组再根据是否行Ⅰ/R 和引流分为2组,每组8只].单纯引流组只引流180 mⅠn淋巴液不行Ⅰ/R损伤;Ⅰ/R、VR+引流组行肠系膜上动脉夹闭60 mⅠn再灌注120 mⅠn;Ⅰ/R+引流组同时行肠淋巴液引流180 mⅠn.胃造口组大鼠均先行胃造口手术,分别给予不同营养5 d后造模,各引流组同前进行肠淋巴液引流180 mⅠn.手术完毕后分别取血清和淋巴液,定量检测内毒素,酶联免疫吸附试验(ELⅠSA)定量检测炎症因子以及HMGB1.结果 Ⅰ/R+引流组淋巴液中内毒素、炎症因子以及HMGBl均高于单纯引流组[均P＜0.05,白细胞介素(ⅠL)-6(30±8)pg/ml比(20±6)pg/ml,内毒素(0 029±0.011)U/ml比(0 008±0 005)U/ml];Ⅰ/R+引流组血清中内毒素、炎症因子均低于Ⅰ/R组(均P＜0 05).在胃造口组中,N 组和EN组的淋巴液中肿瘤坏死因子(TNF)-α与HMGBl均高于PUFA组[(46±17)pg/ml、(54±16)pg/ml比(28±9)pg/ml,(4.8±1.6)ng/ml、(5.3±1.8)ns/ml比(3.0±1.0)ng/ml,均P＜0.05].PUFA(Ⅰ/R)组血清中内毒素、炎症因子以及HMGBl均低于N(Ⅰ/R)组(均P＜0.05),PUFA(Ⅰ/R+引流)组血清中TNF-α与HMGBl均低于N(Ⅰ/R+引流)组(均P＜0 05).结论 引流肠淋巴液能够降低肠道Ⅰ/R损伤时内毒素、炎症因子和HMGB1的水平,减轻大鼠肠道Ⅰ/R引起的损伤.ω-3PUFA的干预对于肠道Ⅰ/R引起的损伤有一定的保护作用,对于减轻炎症反应有积极作用.
目的 觀察大鼠腸道缺血再灌註(Ⅰ/R)損傷時腸淋巴液引流對高遷移率族蛋白1(HMGB1)、炎癥因子和內毒素的影響以及ω-3多不飽和脂肪痠(ω-3 PUFA)榦預的效果.方法 72隻SD大鼠隨機區組法隨機分為單純引流組、Ⅰ/R組、Ⅰ/R+引流組(每組8隻)和胃造口組[正常飲食(N)組、普通腸內營養(EN)組、普通腸內營養加ω-3 PUFA(PUFA)3大組,每大組再根據是否行Ⅰ/R 和引流分為2組,每組8隻].單純引流組隻引流180 mⅠn淋巴液不行Ⅰ/R損傷;Ⅰ/R、VR+引流組行腸繫膜上動脈夾閉60 mⅠn再灌註120 mⅠn;Ⅰ/R+引流組同時行腸淋巴液引流180 mⅠn.胃造口組大鼠均先行胃造口手術,分彆給予不同營養5 d後造模,各引流組同前進行腸淋巴液引流180 mⅠn.手術完畢後分彆取血清和淋巴液,定量檢測內毒素,酶聯免疫吸附試驗(ELⅠSA)定量檢測炎癥因子以及HMGB1.結果 Ⅰ/R+引流組淋巴液中內毒素、炎癥因子以及HMGBl均高于單純引流組[均P＜0.05,白細胞介素(ⅠL)-6(30±8)pg/ml比(20±6)pg/ml,內毒素(0 029±0.011)U/ml比(0 008±0 005)U/ml];Ⅰ/R+引流組血清中內毒素、炎癥因子均低于Ⅰ/R組(均P＜0 05).在胃造口組中,N 組和EN組的淋巴液中腫瘤壞死因子(TNF)-α與HMGBl均高于PUFA組[(46±17)pg/ml、(54±16)pg/ml比(28±9)pg/ml,(4.8±1.6)ng/ml、(5.3±1.8)ns/ml比(3.0±1.0)ng/ml,均P＜0.05].PUFA(Ⅰ/R)組血清中內毒素、炎癥因子以及HMGBl均低于N(Ⅰ/R)組(均P＜0.05),PUFA(Ⅰ/R+引流)組血清中TNF-α與HMGBl均低于N(Ⅰ/R+引流)組(均P＜0 05).結論 引流腸淋巴液能夠降低腸道Ⅰ/R損傷時內毒素、炎癥因子和HMGB1的水平,減輕大鼠腸道Ⅰ/R引起的損傷.ω-3PUFA的榦預對于腸道Ⅰ/R引起的損傷有一定的保護作用,對于減輕炎癥反應有積極作用.
목적 관찰대서장도결혈재관주(Ⅰ/R)손상시장림파액인류대고천이솔족단백1(HMGB1)、염증인자화내독소적영향이급ω-3다불포화지방산(ω-3 PUFA)간예적효과.방법 72지SD대서수궤구조법수궤분위단순인류조、Ⅰ/R조、Ⅰ/R+인류조(매조8지)화위조구조[정상음식(N)조、보통장내영양(EN)조、보통장내영양가ω-3 PUFA(PUFA)3대조,매대조재근거시부행Ⅰ/R 화인류분위2조,매조8지].단순인류조지인류180 mⅠn림파액불행Ⅰ/R손상;Ⅰ/R、VR+인류조행장계막상동맥협폐60 mⅠn재관주120 mⅠn;Ⅰ/R+인류조동시행장림파액인류180 mⅠn.위조구조대서균선행위조구수술,분별급여불동영양5 d후조모,각인류조동전진행장림파액인류180 mⅠn.수술완필후분별취혈청화림파액,정량검측내독소,매련면역흡부시험(ELⅠSA)정량검측염증인자이급HMGB1.결과 Ⅰ/R+인류조림파액중내독소、염증인자이급HMGBl균고우단순인류조[균P＜0.05,백세포개소(ⅠL)-6(30±8)pg/ml비(20±6)pg/ml,내독소(0 029±0.011)U/ml비(0 008±0 005)U/ml];Ⅰ/R+인류조혈청중내독소、염증인자균저우Ⅰ/R조(균P＜0 05).재위조구조중,N 조화EN조적림파액중종류배사인자(TNF)-α여HMGBl균고우PUFA조[(46±17)pg/ml、(54±16)pg/ml비(28±9)pg/ml,(4.8±1.6)ng/ml、(5.3±1.8)ns/ml비(3.0±1.0)ng/ml,균P＜0.05].PUFA(Ⅰ/R)조혈청중내독소、염증인자이급HMGBl균저우N(Ⅰ/R)조(균P＜0.05),PUFA(Ⅰ/R+인류)조혈청중TNF-α여HMGBl균저우N(Ⅰ/R+인류)조(균P＜0 05).결론 인류장림파액능구강저장도Ⅰ/R손상시내독소、염증인자화HMGB1적수평,감경대서장도Ⅰ/R인기적손상.ω-3PUFA적간예대우장도Ⅰ/R인기적손상유일정적보호작용,대우감경염증반응유적겁작용.
Objective To investigate the effects of lymphatic drainage and ω-3 polyunsaturated fatty acid (ω-3PUFA) on high mobility group box 1 (HMGB1) , inflammatory cytokines and endotoxin in rats with intestinal ischemia-reperfusion (Ⅰ/R) injury. Methods A total of 72 SD rats were randomly divided into drainage-alone group, Ⅰ/R group, ischemia-reperfusion plus drainage (Ⅰ/R+D) group (n=8 each)and 3 groups with 16 rats undergoing gastrostomy in each group: normal diet (N) group, enteral nutrition (EN) group and enteral nutrition & ω-3PUFA (PUFA) group. And they were further divided into 2 subgroups (n=8). The rats in Ⅰ/R and Ⅰ/R+D groups were subjected to a 60-min ischemia follow by 120-min reperfusion injury of superior mesenteric artery. When the rats suffered Ⅰ/R injury, intestinal lymph was drained for 180 min in the Ⅰ/R+D group. The rats in the drainage-alone group received 180-min lymph drainage without Ⅰ/R injury. After 5 days with different nutrition regimes, the models were established similarly. The rats in the Ⅰ/R+D sub-groups were treated with intestinal lymph drainage for 180 min. The serum and lymph samples were collected post-operatively. Endotoxin was detected by a Limulus kit. The inflammatory cytokines and high mobility group box 1 (HMGB1) were analyzed by enzyme-linked immunosorbent assay (ELISA).Results Endotoxin, inflammatory cytokines and lymphatic HMGB1 of lymphatic in the Ⅰ/R+D group were higher than those in the drainage-alone group [all P＜0.05 , IL-6 :(30±8) pg/ml vs (20±6) pg/ml, endotoxin: (0.029±0.011) U/ml vs (0.008+0.005) U/ml].The serum levels of endotoxin and inflammatory cytokines in the Ⅰ/R+ D group were lower than those in the Ⅰ/R group (P＜0.05).The lymphatic levels of TNF-a (tumor necrosis factor-alpha) and HMGB1 in the N and EN groups were higher than those in the PUFA group[TNF-α: (46±17)pg/ml, (54±16)pg/ml vs(28±9) pg/ml, HMGB1: (4.8±1.6) ng/ml, (5.3±1.8) ng/ml, (3.0±1.0) ng/ml, all P＜0.05) ].The serum levels of endotoxin, inflammatory cytokines and HMGB1 in the PUFA(l/R) group were lower than those in the N(Ⅰ/R) group (F＜0.05).The levels of TNF-a and HMGB1 were lower in the PUFA (Ⅰ/R+D) group than those in the N(Ⅰ/R+ D) group (both P＜0.05).Conclusion Lymphatic drainage may reduce the levels of endotoxin, inflammatory cytokines and HMGB1 so as to alleviate the intestinal Ⅰ/R injury. The intervention of ω-3PUFA has some protective effect through relieving inflammation.
