CAJ | 학술논문

　　目的探索大鼠急性肠缺血模型的血清肠脂肪酸结合蛋白（I-FABP）和D-乳酸(D-Lac)浓度与缺血时间、肠黏膜损伤的相关性。方法建立大鼠肠系膜前动脉缺血模型，按照缺血时间随机分为6组：假手术组（空白对照），缺血30min，60min，90min，120min，150min组，每组10只。ELISA法分析各组血清I-FABP和D-Lac水平。免疫组化法评估受损肠黏膜组织I-FABP含量。对病变组织进行损伤评分，评估血清I-FABP和D-Lac水平与组织损伤的相关性。结果大鼠肠缺血30min时血清I-FABP浓度明显升高，于90min达到峰值[（1741.37±184.12）mg/L]，I-FABP抗体染色阳性率达72.5%(P＜0.05)；大鼠肠缺血60min时血清D-Lac浓度开始升高，随缺血时间延长，D-Lac浓度升高越明显（P＜0.05）。小肠黏膜损伤评分结果提示，缺血时间越长，组织损伤评分越高。Spearman等级相关非参数检验结果表明，血清D-Lac浓度与组织损伤正相关（r＝1）；血清I-FABP浓度与组织损伤评分无相关性（r＝0.6）。结论血清I-FABP在大鼠急性肠缺血早期明显升高，达到峰值后随缺血时间的延长而下降，血清D-Lac在缺血中后期升高明显，可反映肠组织损伤程度。
　　목적탐색대서급성장결혈모형적혈청장지방산결합단백（I-FABP）화D-유산(D-Lac)농도여결혈시간、장점막손상적상관성。방법건립대서장계막전동맥결혈모형，안조결혈시간수궤분위6조：가수술조（공백대조），결혈30min，60min，90min，120min，150min조，매조10지。ELISA법분석각조혈청I-FABP화D-Lac수평。면역조화법평고수손장점막조직I-FABP함량。대병변조직진행손상평분，평고혈청I-FABP화D-Lac수평여조직손상적상관성。결과대서장결혈30min시혈청I-FABP농도명현승고，우90min체도봉치[（1741.37±184.12）mg/L]，I-FABP항체염색양성솔체72.5%(P＜0.05)；대서장결혈60min시혈청D-Lac농도개시승고，수결혈시간연장，D-Lac농도승고월명현（P＜0.05）。소장점막손상평분결과제시，결혈시간월장，조직손상평분월고。Spearman등급상관비삼수검험결과표명，혈청D-Lac농도여조직손상정상관（r＝1）；혈청I-FABP농도여조직손상평분무상관성（r＝0.6）。결론혈청I-FABP재대서급성장결혈조기명현승고，체도봉치후수결혈시간적연장이하강，혈청D-Lac재결혈중후기승고명현，가반영장조직손상정도。
Objective To investigate the correlation of the serum levels of intestinal fatty acid binding protein (I-FABP) and D-lactate (D-Lac) with ischemic time and intestinal mucosa injury in rats with acute mesenteric ischemia. Methods A total of 60 rats were randomly and equally divided into 6 groups, that is, sham-operation group and 5 mesenteric ischemia groups according to mesenteric artery occluded for 30, 60, 90, 120 and 150 min respectively. Their serum levels of I-FABP and D-Lac were determined by ELISA. The content of I-FABP in the damaged intestinal mucosa was measured by immunohistochemical assay. Histopathological analysis was performed in the injured intestinal mucosa to evaluate the score of injury. The correlation of serum levels of I-FABP and D-Lac with tissue injury was analyzed. Results The serum I-FABP level was significantly increased from 30 min after ischemia, and reached a peak at 90 min [(1741.37±184.12)mg/L], and the cells positive to I-FABP accounted for 72.5%(P<0.05). The serum level of D-Lac was significantly increased from 60 min after ischemia and showed a time-dependent manner (P<0.05). The score of injury was also increased with the extent of ischemic time. Spearman’s rank correlation non-parameter test indicated that the serum level of D-Lac was positively correlated with intestinal mucosa injury (r=1), but that of I-FABP had no such correlation (r=0.6). Conclusions Serum I-FABP is increased at the early stage of acute mesenteric ischemia, and then after reaching peak, decreased with the elapse of ischemic time. Serum D-Lac is obviously increased at the late stage, and might be used to predict the severity of intestinal ischemic injury.