【摘要】 目的 观察缺血后处理减轻肠缺血再灌注引起的小肠及远隔脏器损伤的效果,并探讨其机制。方法 将家兔48只随机分为假手术组、缺血再灌注组、缺血后处理组,每组16只。再灌注2h后采集各组动脉血、静脉血及部分肠道组织、肝、肺组织,测动脉血中TNF-α、IL-1β、IL-6、IL-10水平,测静脉血中ALT、AST、BUN、Cr、LDH、CK-MB活性,测内毒素水平,测定血清及小肠、肝、肺组织MDA、MPO、CAT、SOD水平,HE染色,观察肠黏膜损伤情况,细菌培养观察细菌易位率。结果 与缺血再灌注组比较,缺血后处理组血清及小肠、肝、肺组织中MDA、MPO水平明显降低,SOD、CAT水平明显升高,静脉血ALT、AST、LDH、CK-MB、BUN下降;动脉血中TNF-α、IL-1β、IL-6、内毒素降低,IL-10水平升高,肠黏膜损伤评分明显降低。结论 缺血后处理可以减轻肠黏膜损伤,减少内毒素易位,促进抗炎因子的激活,抑制炎性介质的过度释放,提升小肠组织及远隔脏器的氧自由基的抗氧化能力,减轻小肠及远隔脏器组织损伤。更多还原

【Abstract】 Objective To observe the effects and mechanism of ischemic postconditioning(IPo)on alleviating injuries of small intestine and remote organs induced by intestinal ischemia-reperfusion(IR).Methods A total of 48 rabbits were divided randomly into three groups(n = 16 in each):the Sham group,the IR group and the IPo group.After 2 hours of reperfusion,arterial and venous blood and tissues of intestine,liver and lung were harvested.The levels of TNF-α,IL-1β,IL-6 and IL-10 in arterial blood and levels of ALT,AST,BUN,Cr,LDH,CK-MB activity and endotoxin in venous blood were tested.MDA,CAT,SOD and MPO levels in serum,small intestine,liver and lung were also measured.HE staining was performed for observation of injured intestinal mucosa.Bacterial translocation rate was calculated after bacteria culture.Results Compared with the IR group,MDA and MPO levels in serum,small intestine,liver and lung decreased in the IPo group,while CAT and SOD levels increased obviously.Compared with the IR group,ALT,AST,LDH.CK-MB and BUN levels in the venous blood,and TNF-α,IL-1β,IL-6 and endotoxin levels in arterial blood were all decreased.IL-10 increased and the intestinal mucosal injury score decreased obviously.Conclusion Ischemic post conditioning can decrease the damage of intestinal mucosa,reduce endotoxin translocation,promote activation of anti-inflammatory cytokines,inhibit excessive release of inflammatory mediators,enhance the antioxidant capacity of intestine and remote organs,reduce injuries to the small intestine and remote organs.更多还原