CAJ | 학술논문

目的探讨一氧化氮(NO)在大鼠小肠移植缺血再灌注损伤(IRI)和急性排斥反应(AR)中作用.方法建立同种大鼠原位小肠移植模型,采用随机数字表法将受鼠分为4组.移植对照组、左旋精氨酸(L-Arg)组、左旋硝基精氨酸甲酯(L-NAME)Ⅰ组(Ⅰ组)和L-NAMEⅡ组(Ⅱ组)受鼠于手术当天开始分别每天给予生理盐水、L-Arg 150 mg·kg-1 ·d-1、L-NAME 4和8 mg·kg-1·d-1.术后观察各组受鼠的存活时间,行HE染色观察移植小肠的组织病理学改变,采用免疫组织化学法观察移植小肠一氧化氮合酶(NOS)的活性,以及检测血糖吸收功能和血清NO浓度.结果移植对照组、L-Arg组、Ⅰ组及Ⅱ组受鼠的存活时间分别为(11.7±1.2)d、(10.2±1.0)d、(12.3±1.5)d和(17.3±1.9)d,Ⅱ组受鼠的存活时间明显延长(P＜0.01).与移植对照组相比,L-Arg组和Ⅰ组IRI的Park评分下降,IRI减轻；Ⅱ组Park评分显著升高(P＜0.01),IRI加重,但AR明显减轻.与移植对照组相比,IRI期间,Ⅰ组iNOS染色减弱,Ⅱ组iNOS和nNOS染色均减弱；AR期间,Ⅱ组iNOS染色明显减弱.各组血清NO浓度于再灌注后30min逐渐升高.与移植对照组相比,Ⅱ组血 NO浓度的升高延缓.与移植对照组相比,L-Arg组血糖吸收值于再灌注30 min至术后3d明显增高(P＜0.01);Ⅰ组和Ⅱ组血糖吸收值术后处于较低水平.结论 NO在大鼠小肠移植IRI中起到了细胞毒和细胞保护的双重作用；在AR中加重了组织损伤.术后早期补充L-Arg可促进移植肠管对糖类的吸收.
목적 탐토일양화담(NO)재대서소장이식결혈재관주손상(IRI)화급성배척반응(AR)중작용.방법 건립동충대서원위소장이식모형,채용수궤수자표법장수서분위4조.이식대조조、좌선정안산(L-Arg)조、좌선초기정안산갑지(L-NAME)Ⅰ조(Ⅰ조)화L-NAMEⅡ조(Ⅱ조)수서우수술당천개시분별매천급여생리염수、L-Arg 150 mg·kg-1 ·d-1、L-NAME 4화8 mg·kg-1·d-1.술후관찰각조수서적존활시간,행HE염색관찰이식소장적조직병이학개변,채용면역조직화학법관찰이식소장일양화담합매(NOS)적활성,이급검측혈당흡수공능화혈청NO농도.결과 이식대조조、L-Arg조、Ⅰ조급Ⅱ조수서적존활시간분별위(11.7±1.2)d、(10.2±1.0)d、(12.3±1.5)d화(17.3±1.9)d,Ⅱ조수서적존활시간명현연장(P＜0.01).여이식대조조상비,L-Arg조화Ⅰ조IRI적Park평분하강,IRI감경；Ⅱ조Park평분현저승고(P＜0.01),IRI가중,단AR명현감경.여이식대조조상비,IRI기간,Ⅰ조iNOS염색감약,Ⅱ조iNOS화nNOS염색균감약；AR기간,Ⅱ조iNOS염색명현감약.각조혈청NO농도우재관주후30min축점승고.여이식대조조상비,Ⅱ조혈 NO농도적승고연완.여이식대조조상비,L-Arg조혈당흡수치우재관주30 min지술후3d명현증고(P＜0.01);Ⅰ조화Ⅱ조혈당흡수치술후처우교저수평.결론 NO재대서소장이식IRI중기도료세포독화세포보호적쌍중작용；재AR중가중료조직손상.술후조기보충L-Arg가촉진이식장관대당류적흡수.
Objective To evaluate the role of nitric oxide (NO) in ischemia reperfusion injury (IRI) and acute rejection (AR) of intestinal transplantation in rats.Methods The rat orthotopic intestinal transplantation was performed. Animals were assigned to the following 4 groups with random methods:transplant control group,L-arginine (L-Arg) group,NG-Nitro-L-arginine methyl ester (L-NAME) Ⅰ group (group Ⅰ ) and L-NAME Ⅱ group (group Ⅱ ).The rats in different group were given saline,L-Arg (150 mg· kg-1 · d-1 ),L-NAME (4 and 8 mg· kg-1 · d-1 ) injection respectively from the operative day.The recipient survival time was observed.The pathologic changes were observed by HE staining.The activity of nitric oxide synthases (NOS) was measured by using immunohistochemistry.The abilities of glucose absorption and serum NO levels were tested.Results The recipient survival timein transplant control group,L-Arg group,group Ⅰ and group Ⅱ were (11.7 ± 1.2),(10.2 ± 1.0),( 12.3 ± 1.5) and ( 17.3 ± 1.9) days respectively,and the survival in group Ⅱ was prolonged significantly (P＜0.01).As compared with control group,the Park scores in L-Arg group and group Ⅰ were reduced,and IRI were attenuated; the Park score in group Ⅱ was increased (P＜0.01),the IRI was aggravated,but the AR was attenuated.As compared with control group,during the IRI period,the iNOS staining in group Ⅰ was decreased,and both iNOS and nNOS staining in group Ⅱ was decreased; during the AR period,the iNOS staining in group Ⅱ was decreased obviously.The serum NO levels were increased gradually in all groups.As compared with control group,the increase of serum NO level in group Ⅱ was delayed.As compared with control group,the glucose absorption levels in L-Arg group were increased significantly from 30 min after reperfusion to POD-3 (P＜0.01),and the postoperative glucose absorption levels in groups Ⅰ and Ⅱ maintained the low levels.Conclusion NO may play a dual role as both cytotoxic and cytoprotective effects in IRI,and aggravate mucosal damage in AR in rats intestinal transplantation.The glucose absorptive capacity of graft is promoted by supplementation of LArg at early postoperative period.