CAJ | 학술논문

目的研究高渗盐溶液对肠缺血-再灌注兔肠屏障功能的保护作用及其机制.方法新西兰白兔随机(随机数字法)分为5组,每组18只:正常对照组、缺血-再灌注组(IIR)、生理盐水治疗组(NS)、4％高渗氯化钠溶液(4％HS)治疗组、7.5％高渗氯化钠溶液(7.5％HS)治疗组.实验组采用完全夹闭肠系膜上动脉(SMA)l h,开放再灌注的方法制备肠缺血-再灌注模型.3个治疗组均在SMA开放前5 min输注相应质量分数的氯化钠溶液.选择缺血前与再灌注后2、4、6h4个时间点取血测定LPS、D-Lac水平.再灌注6h每组抽取8只动物处死,取其小肠测定组织中的MPO、MDA、SOD浓度,光镜下对病理形态进行观察,TUNEL法检测肠上皮细胞凋亡.结果 (1)各缺血-再灌注组再灌注后肠屏障指标LPS、D-Lac均显著升高；再灌注6h肠MDA、MPO、Chiu氏病理评分及肠黏膜凋亡指数(AI)均显著升高(P＜0.05)；而SOD在IIR组与NS组低于正常对照组,两组高渗盐溶液治疗组均高于正常对照组(P＜0.05).(2)两组高渗溶液治疗组LPS、D-Lac均低于IIR组与NS组,其中7.5％ HS组更为明显(P＜0.05)；再灌注6h肠MDA、MPO、Chiu氏病理评分均低于IIR组与NS组,其中7.5％ HS组更为明显(P＜0.05)；而SOD与AI在高渗盐溶液治疗组均高于IIR组与NS组,其中7.5％HS组更为明显(P＜0.05)结论高渗氯化钠溶液治疗对肠缺血-再灌注损伤具有保护作用,一定的范围内随着盐质量分数的增加而效应增强.
목적 연구고삼염용액대장결혈-재관주토장병장공능적보호작용급기궤제.방법 신서란백토수궤(수궤수자법)분위5조,매조18지:정상대조조、결혈-재관주조(IIR)、생리염수치료조(NS)、4％고삼록화납용액(4％HS)치료조、7.5％고삼록화납용액(7.5％HS)치료조.실험조채용완전협폐장계막상동맥(SMA)l h,개방재관주적방법제비장결혈-재관주모형.3개치료조균재SMA개방전5 min수주상응질량분수적록화납용액.선택결혈전여재관주후2、4、6h4개시간점취혈측정LPS、D-Lac수평.재관주6h매조추취8지동물처사,취기소장측정조직중적MPO、MDA、SOD농도,광경하대병리형태진행관찰,TUNEL법검측장상피세포조망.결과 (1)각결혈-재관주조재관주후장병장지표LPS、D-Lac균현저승고；재관주6h장MDA、MPO、Chiu씨병리평분급장점막조망지수(AI)균현저승고(P＜0.05)；이SOD재IIR조여NS조저우정상대조조,량조고삼염용액치료조균고우정상대조조(P＜0.05).(2)량조고삼용액치료조LPS、D-Lac균저우IIR조여NS조,기중7.5％ HS조경위명현(P＜0.05)；재관주6h장MDA、MPO、Chiu씨병리평분균저우IIR조여NS조,기중7.5％ HS조경위명현(P＜0.05)；이SOD여AI재고삼염용액치료조균고우IIR조여NS조,기중7.5％HS조경위명현(P＜0.05)결론 고삼록화납용액치료대장결혈-재관주손상구유보호작용,일정적범위내수착염질량분수적증가이효응증강.
Objective To study the protective effect and mechanism of hypertonic saline solution on intestinal barrier function in rabbits intestinal ischemia reperfusion models.Methods Rabbits were randomly (random number) divided into five groups (n =18):control group,intestinal ischemia reperfusion (IIR) group,normal saline group (NS),4％ hypertonic saline (4％ HS) group,and 7.5％ hypertonic saline (7.5％ HS) group.The intestinal ischemia reperfusion models were produced by clamping super mesenteric artery (SMA) for 1 hour and declamping SMA for 6 hours.The corresponding sodium chloride solution was infused in the 3 treatment groups in 5 mins before declamping SMA.Before intestinal ischemia-reperfusion and 2,4,6 hours after,levels of LPS,D-Lac in plasma were measured; 6 hours after intestinal ischemia reperfusion,8 rabbits per group were killed to measure levels of MPO,MDA,SOD in intestinal tissues.Meanwhile intestinal morphological changes and intestinal apoptosis were observed.Results LPS and D-Lac were significantly increased after ischemia reperfusion (P ＜ 0.05) ; MDA,MPO,Chiu's intestinal pathology score and apoptosis index (AI) was significantly increased 6 hours after intestinal reperfusion (P ＜ 0.05) ; SOD of IIR group and NS group was lower than that of the control group,while it was higher in both of hypertonic saline treatment groups (P ＜ 0.05).(2) In both of hypertonic saline treatment groups,LPS and D-Lac were lower than those of the IIR group and NS group,especially in 7.5％ HS group (P＜0.05) ; MDA,MPO,Chiu's intestinal pathological score and apoptosis index were lower than those of the IIR group and NS group,while SOD and apoptosis index (AI) were higher than them,especially in 7.5％ HS group (P ＜ 0.05).Conclusions Hypertonic saline had the protective effect on intestine barrier function during intestinal ischemia reperfusion.With the increasing concentration of hypertonic saline among certain range,the protective effects were gradually strengthened.