天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2014年
2期
167-169
,共3页
刘霞%张志广%李熳%张雪莲
劉霞%張誌廣%李熳%張雪蓮
류하%장지엄%리만%장설련
血小板聚集抑制剂%阿司匹林%氯吡格雷%创伤和损伤%小肠%通透性%菌群失调
血小闆聚集抑製劑%阿司匹林%氯吡格雷%創傷和損傷%小腸%通透性%菌群失調
혈소판취집억제제%아사필림%록필격뢰%창상화손상%소장%통투성%균군실조
platelet aggregation inhibitors%ASPIRIN%CLOPIDOGREL%wounds and injuries%intestine,small%perme-ability%dysbacteriosis
目的：探讨双联抗血小板聚集药物对大鼠小肠损伤的情况。方法 SD大鼠80只随机分为阴性对照组、阿司匹林组、氯吡格雷组、阿司匹林联合氯吡格雷组（双抗组），每组20只，每天分别予生理盐水、阿司匹林10.41 mg/kg、氯吡格雷7.81 mg/kg、阿司匹林10.41 mg/kg联合氯吡格雷7.81 mg/kg灌胃，共14 d。所有大鼠于末次给药后手术，观察小肠损伤情况，取空肠液行细菌培养，溴化乙锭（EB）行小肠通透性检测，按照Chiu方法进行小肠黏膜病理损伤评分。结果各实验组大鼠小肠黏膜均出现不同程度损伤，病理损伤评分均高于阴性对照组，且以双抗组最高（3.450±1.356）分。与对照组[（54.012±3.513）μg/g]相比，各实验组大鼠小肠通透性均明显增高，双抗组高于阿司匹林组及氯吡格雷组（μg/g：130.533±29.631 vs 90.965±3.765 vs 66.800±4.853，P＜0.001）。双抗组大鼠空肠液细菌总量较对照组明显增多（CFU/mL：61924.805±1751.159 vs 18154.280±1153.376，P＜0.001），肠杆菌与肠球菌比例较对照组明显下降（0.220±0.089 vs 1.007±0.148，P＜0.001）。结论常规剂量双联抗血小板聚集药物的使用较单一用药造成大鼠小肠损伤程度加重，肠道细菌数量增多，菌群失调、小肠通透性的增高都可能是小肠黏膜损伤的重要表现。
目的：探討雙聯抗血小闆聚集藥物對大鼠小腸損傷的情況。方法 SD大鼠80隻隨機分為陰性對照組、阿司匹林組、氯吡格雷組、阿司匹林聯閤氯吡格雷組（雙抗組），每組20隻，每天分彆予生理鹽水、阿司匹林10.41 mg/kg、氯吡格雷7.81 mg/kg、阿司匹林10.41 mg/kg聯閤氯吡格雷7.81 mg/kg灌胃，共14 d。所有大鼠于末次給藥後手術，觀察小腸損傷情況，取空腸液行細菌培養，溴化乙錠（EB）行小腸通透性檢測，按照Chiu方法進行小腸黏膜病理損傷評分。結果各實驗組大鼠小腸黏膜均齣現不同程度損傷，病理損傷評分均高于陰性對照組，且以雙抗組最高（3.450±1.356）分。與對照組[（54.012±3.513）μg/g]相比，各實驗組大鼠小腸通透性均明顯增高，雙抗組高于阿司匹林組及氯吡格雷組（μg/g：130.533±29.631 vs 90.965±3.765 vs 66.800±4.853，P＜0.001）。雙抗組大鼠空腸液細菌總量較對照組明顯增多（CFU/mL：61924.805±1751.159 vs 18154.280±1153.376，P＜0.001），腸桿菌與腸毬菌比例較對照組明顯下降（0.220±0.089 vs 1.007±0.148，P＜0.001）。結論常規劑量雙聯抗血小闆聚集藥物的使用較單一用藥造成大鼠小腸損傷程度加重，腸道細菌數量增多，菌群失調、小腸通透性的增高都可能是小腸黏膜損傷的重要錶現。
목적：탐토쌍련항혈소판취집약물대대서소장손상적정황。방법 SD대서80지수궤분위음성대조조、아사필림조、록필격뢰조、아사필림연합록필격뢰조（쌍항조），매조20지，매천분별여생리염수、아사필림10.41 mg/kg、록필격뢰7.81 mg/kg、아사필림10.41 mg/kg연합록필격뢰7.81 mg/kg관위，공14 d。소유대서우말차급약후수술，관찰소장손상정황，취공장액행세균배양，추화을정（EB）행소장통투성검측，안조Chiu방법진행소장점막병리손상평분。결과각실험조대서소장점막균출현불동정도손상，병리손상평분균고우음성대조조，차이쌍항조최고（3.450±1.356）분。여대조조[（54.012±3.513）μg/g]상비，각실험조대서소장통투성균명현증고，쌍항조고우아사필림조급록필격뢰조（μg/g：130.533±29.631 vs 90.965±3.765 vs 66.800±4.853，P＜0.001）。쌍항조대서공장액세균총량교대조조명현증다（CFU/mL：61924.805±1751.159 vs 18154.280±1153.376，P＜0.001），장간균여장구균비례교대조조명현하강（0.220±0.089 vs 1.007±0.148，P＜0.001）。결론상규제량쌍련항혈소판취집약물적사용교단일용약조성대서소장손상정도가중，장도세균수량증다，균군실조、소장통투성적증고도가능시소장점막손상적중요표현。
Objective To investigate the effect of dual antiplatelet drugs on the intestinal damage in rats. Meth-ods Eighty SD rats were randomly allocated into four groups:control group (normal saline, n=20), aspirin group (10.41 mg/kg, n=20), clopidogrel group (7.81 mg/kg, n=20) and clopidogrel combined aspirin group (n=20). Each group was given intra-gastric administration of drugs once per day for 14 days. All rats received operation after the final intragastric administration. The intestinal injury was observed. The jejunal fluid was taken for bacterial culture. The intestinal permeability was detected by ethidium bromide (EB) method. The small intestinal mucosal injury was estimated by Chiu method. Results The differ-ent degrees of small intestinal mucosal injury were found in four groups. The scores of pathological lesions were significantly higher in aspirin group, clopidogrel group and clopidogrel combined aspirin group than those of control group (P<0.05). The dual antiplatelet group showed the highest score (3.450±1.356). The small intestinal permeability was significantly increased in experiment groups compared with that of control group (54.012±3.513μg/g, P<0.05). There was a significantly higher small intestinal permeability in dual antiplatelet group than that of aspirin group and clopidogrel group (μg/g:130.533 ± 29.631 vs 90.965±3.765 vs 66.800±4.853, P<0.001). The total jejunal bacteria was significantly increased in dual antiplate-let group than that of control group (CFU/mL:61924.805±1751.159 vs 18154.280±1153.376, P<0.001). The ratio of entero-bacterium and enterococcus was significantly decreased in dual antiplatelet group compared with that of control group (0.220±0.089 vs 1.007±0.148, P<0.001). Conclusion The routine dose of dual antiplatelet drug aggravates the small intes-tinal injury in rats compared with that of single drug. The manifestations of intestinal mucosal injury include increased intes-tinal bacteria, dysbacteriosis, and increased small intestinal permeability.
