中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2014年
10期
985-989
,共5页
董千铜%章晓东%余震%闫竞一%陈笑雷
董韆銅%章曉東%餘震%閆競一%陳笑雷
동천동%장효동%여진%염경일%진소뢰
术后疲劳综合征%5-羟色胺%色氨酸%支链氨基酸%氟西汀%大鼠
術後疲勞綜閤徵%5-羥色胺%色氨痠%支鏈氨基痠%氟西汀%大鼠
술후피로종합정%5-간색알%색안산%지련안기산%불서정%대서
Postoperative fatigue syndrome%5-hydroxytryptamine%Tryptophan%Branched chain amino acid%Fluoxetine%Rats
目的：研究观察支链氨基酸（BCAA）和相关拮抗剂作用于中枢5-羟色胺（5-HT）代谢通路后大鼠术后疲劳的改变情况，并探讨5-HT在术后疲劳综合征（POFS）发生发展中的作用。方法50只SD大鼠随机分为5组，每组10只，对照组分别为假手术组和模型组（均注射生理盐水）；干预组分别为注射中性氨基酸转运体抑制剂（BCH）的BCH组、注射5-HT重摄取抑制剂氟西汀的氟西汀组和注射BCAA（缬氨酸、亮氨酸、异亮氨酸以5∶3∶2比例的混合液）的BCAA组。除假手术组仅开腹翻动肠袢外，其余各组行70％中段小肠切除端端吻合术。各组术前1 h、术后1、2、3、4 d腹腔注射给药，每天1次。观察手术前后各组大鼠的一般情况；术后第1～7天分别进行Morris水迷宫试验（包括隐藏平台获得试验和空间搜索试验）以检测大鼠学习记忆能力和鼠尾悬吊试验（检测大鼠体力耐力）评估大鼠疲劳程度；术后第8天采用高效液相色谱-荧光检测器检测大鼠脑组织（海马、纹状体及下丘脑）中的色氨酸、5-HT及5-羟吲哚乙酸（5-HIAA）的水平。结果与模型组相比，干预组大鼠一般情况较好，术后疲劳程度减轻。在隐藏平台获得试验中，模型组穿越平台次数最少，与其他4组比较，差异有统计学意义（P＜0．05）；模型组与BCAA组的潜伏时间最长，与假手术组和BCH组比较，差异也有统计学意义（P＜0．05）；在空间搜索试验中，模型组与BCAA组的穿越平台次数最少，模型组潜伏期时间与干预组比较差异无统计学意义（P＞0．05）。鼠尾悬吊试验显示，BCH组和BCAA组大鼠体力耐力较模型组和氟西汀组更好（P＜0．05）。高效液相-荧光检测法检测，3个干预组的脑组织色氨酸水平均明显低于模型组（P＜0．01）；模型组海马5-HT水平高于BCH组和氟西汀组（P＜0．05）；纹状体中5-HT水平比较，假手术组最低，模型组与干预组差异无统计学意义（P＞0．05）；模型组下丘脑5-HIAA含量高于氟西汀组（P＜0．05），但与BCH组和BCAA组比较，差异无统计学意义（P＞0．05）。结论 BCAA以及相关拮抗剂BCH和氟西汀，能降低大鼠神经中枢对色氨酸的摄取，减少大脑5-HT合成，改善大鼠POFS。
目的：研究觀察支鏈氨基痠（BCAA）和相關拮抗劑作用于中樞5-羥色胺（5-HT）代謝通路後大鼠術後疲勞的改變情況，併探討5-HT在術後疲勞綜閤徵（POFS）髮生髮展中的作用。方法50隻SD大鼠隨機分為5組，每組10隻，對照組分彆為假手術組和模型組（均註射生理鹽水）；榦預組分彆為註射中性氨基痠轉運體抑製劑（BCH）的BCH組、註射5-HT重攝取抑製劑氟西汀的氟西汀組和註射BCAA（纈氨痠、亮氨痠、異亮氨痠以5∶3∶2比例的混閤液）的BCAA組。除假手術組僅開腹翻動腸袢外，其餘各組行70％中段小腸切除耑耑吻閤術。各組術前1 h、術後1、2、3、4 d腹腔註射給藥，每天1次。觀察手術前後各組大鼠的一般情況；術後第1～7天分彆進行Morris水迷宮試驗（包括隱藏平檯穫得試驗和空間搜索試驗）以檢測大鼠學習記憶能力和鼠尾懸弔試驗（檢測大鼠體力耐力）評估大鼠疲勞程度；術後第8天採用高效液相色譜-熒光檢測器檢測大鼠腦組織（海馬、紋狀體及下丘腦）中的色氨痠、5-HT及5-羥吲哚乙痠（5-HIAA）的水平。結果與模型組相比，榦預組大鼠一般情況較好，術後疲勞程度減輕。在隱藏平檯穫得試驗中，模型組穿越平檯次數最少，與其他4組比較，差異有統計學意義（P＜0．05）；模型組與BCAA組的潛伏時間最長，與假手術組和BCH組比較，差異也有統計學意義（P＜0．05）；在空間搜索試驗中，模型組與BCAA組的穿越平檯次數最少，模型組潛伏期時間與榦預組比較差異無統計學意義（P＞0．05）。鼠尾懸弔試驗顯示，BCH組和BCAA組大鼠體力耐力較模型組和氟西汀組更好（P＜0．05）。高效液相-熒光檢測法檢測，3箇榦預組的腦組織色氨痠水平均明顯低于模型組（P＜0．01）；模型組海馬5-HT水平高于BCH組和氟西汀組（P＜0．05）；紋狀體中5-HT水平比較，假手術組最低，模型組與榦預組差異無統計學意義（P＞0．05）；模型組下丘腦5-HIAA含量高于氟西汀組（P＜0．05），但與BCH組和BCAA組比較，差異無統計學意義（P＞0．05）。結論 BCAA以及相關拮抗劑BCH和氟西汀，能降低大鼠神經中樞對色氨痠的攝取，減少大腦5-HT閤成，改善大鼠POFS。
목적：연구관찰지련안기산（BCAA）화상관길항제작용우중추5-간색알（5-HT）대사통로후대서술후피로적개변정황，병탐토5-HT재술후피로종합정（POFS）발생발전중적작용。방법50지SD대서수궤분위5조，매조10지，대조조분별위가수술조화모형조（균주사생리염수）；간예조분별위주사중성안기산전운체억제제（BCH）적BCH조、주사5-HT중섭취억제제불서정적불서정조화주사BCAA（힐안산、량안산、이량안산이5∶3∶2비례적혼합액）적BCAA조。제가수술조부개복번동장번외，기여각조행70％중단소장절제단단문합술。각조술전1 h、술후1、2、3、4 d복강주사급약，매천1차。관찰수술전후각조대서적일반정황；술후제1～7천분별진행Morris수미궁시험（포괄은장평태획득시험화공간수색시험）이검측대서학습기억능력화서미현조시험（검측대서체력내력）평고대서피로정도；술후제8천채용고효액상색보-형광검측기검측대서뇌조직（해마、문상체급하구뇌）중적색안산、5-HT급5-간신타을산（5-HIAA）적수평。결과여모형조상비，간예조대서일반정황교호，술후피로정도감경。재은장평태획득시험중，모형조천월평태차수최소，여기타4조비교，차이유통계학의의（P＜0．05）；모형조여BCAA조적잠복시간최장，여가수술조화BCH조비교，차이야유통계학의의（P＜0．05）；재공간수색시험중，모형조여BCAA조적천월평태차수최소，모형조잠복기시간여간예조비교차이무통계학의의（P＞0．05）。서미현조시험현시，BCH조화BCAA조대서체력내력교모형조화불서정조경호（P＜0．05）。고효액상-형광검측법검측，3개간예조적뇌조직색안산수평균명현저우모형조（P＜0．01）；모형조해마5-HT수평고우BCH조화불서정조（P＜0．05）；문상체중5-HT수평비교，가수술조최저，모형조여간예조차이무통계학의의（P＞0．05）；모형조하구뇌5-HIAA함량고우불서정조（P＜0．05），단여BCH조화BCAA조비교，차이무통계학의의（P＞0．05）。결론 BCAA이급상관길항제BCH화불서정，능강저대서신경중추대색안산적섭취，감소대뇌5-HT합성，개선대서POFS。
Objective To observe the change of postoperative fatigue in rats after the effect of branched chain amino acid (BCAA) and associated antagonists on central neurotransmitter 5-HT metabolic pathway, and to investigate the role of 5-HT in the development of postoperative fatigue syndrome (POFS). Methods Fifty SD rats were randomly divided into sham operation group (C group, n=10), model group (M group, n=10), L-type amino acid transporter inhibitor group (L group, n=10), 5-HT uptake inhibitor group (F group, n=10) and branched chain amino acids (B group, n=10). The rats in the C group and the M group were injected with normal saline, while other three groups were respectively injected with BCH, fluoxetine, BCAA(val∶leucine∶isoleucine=5∶3∶2), on preoperative 1 h, postoperative day 1, 2, 3, 4. The rats, except for those in the C group, underwent resection of 70% of the middle small intestine with end-to-end anastomosis. General status of the rats was observed before and after surgery. Morris water maze test, including the hidden platform test and search space test (detecting the learning ability of rats) and tail suspension test (detecting physical endurance of rats) were used to evaluate the degree of POFS from postoperative day 1 to day 7. Concentration of tryptophan (TRP), 5-HT, 5-hydroxyindoleacetic acid (5-HIAA) in different position of brain (hippocampus, striatum, hypothalamus) of rats were measured by high performance liquid chromatography(HPLC) at postoperative day 8. Results As compared to the M group, other four groups showed better general condition and less fatigue. In the hidden platform test, M group showed the least time of crossing platform as compared to other four groups (all P<0.05). Meanwhile, M group and B group performed the longer incubation period than C group and L group (all P<0.05). In search space test, M group and B group showed less time of crossing platform, but there were no significant differences among the groups (all P>0.05). In tail suspension test, M group and F group showed lower score of physical strength than L group and B group(all P<0.05). Levels of TRP in the L, F, B groups were lower compared to the M group (all P<0.01) in brain tissue. The least concentration of striatum 5-HT was found in the C group but there were no significant differences among the M, L, F and B groups. Level of 5-HIAA in the M group, only in hypothalamus, was higher than that in the F group (P<0.05), but no significant differences between the M group and the L and B groups were found. Conclusion BCAA and associated antagonists (BCH, fluoxetine) can improve POFS by reducing the absorption of TRP that results in decreased synthesis of central 5-HT.
