【摘要】 目的探讨人重组生长激素(rhGH)减轻梗阻性黄疸时肠源性细菌及内毒素移位的作用及机制。方法Wister大鼠42只分为3组:假手术组(SO组)、胆总管结扎组(BDL组)及rhGH治疗组(rhGH组)。实验1周后检测各组肝功指标的变化及血浆内毒素水平,取肝、肾、肠系膜淋巴结等肠道外器官组织做细菌培养,电镜观察末端回肠粘膜变化。结果rhGH组多项肝功指标较BDL组明显改善,rhGH组血浆内毒素水平为(0.38±0.03)EU/ml,较BDL组的(0.65±0.04)EU/ml明显降低(P<0.01),与SO组的(0.30±0.02)EU/ml比较差异无统计学意义(P>0.05)。BDL组肝、肾、肠系膜淋巴结中细菌移位率高于另两组,其中肠系膜淋巴结细菌移位率为64.29%,明显高于SO组及rhGH组(P<0.05),后两组之间各部位细菌检出率差别无统计学意义(P>0.05)。电镜显示BDL组肠粘膜上皮细胞坏死,细胞核固缩,线粒体肿胀变性,内质网明显扩张。rhGH组肠粘膜上皮改变较BDL组明显减轻,接近SO组所见。结论应用rhGH可保护梗阻性黄疸时小肠粘膜屏障功能,减少肠源性细菌/内毒素移位的发生。更多还原

【Abstract】 Objective To investigate the effect and mechanism of recombinant human growth hormone (rhGH) alleviate intestinal bacteria and endotoxin translocation in murine obstructive jaundice. Methods 42 Wister rats were divided into three groups: sham operation (SO) group, bile duct ligation (BDL) group, BDL and rhGH treatment (rhGH) group. By the end of the experiment, on day 7, the rats were killed. Liver function analysis and blood endotoxin measurement were performed. Samples were collected from liver, kidney and mesenchymal lymph for bacteria culture. Terminal ileum mucosa was observed under electron microscope. Results In rhGH group, liver function was improved than that in BDL group. The level of endotoxin in rhGH group was (0.38±0.03) EU/ml, which was significantly lower than that in BDL group (0.65±0.04) EU/ml(P<0.01), and similar to that in SO group (0.30±0.02) EU/ml(P > 0.05). In BDL group, bacteria translocation rates in liver, kidney and mesenchymal lymph were much higher than those in other two groups. The bacteria translocation rate in mesenchymal lymph was 64.29%, which was significantly higher than those in SO group and rhGH group (P<0.05). There were no distinct difference of bacteria translocation rate between SO group and rhGH group (P>0.05). As observed under electron microscope ileum mucosa epithelial cell in BDL group were necrotic and organelle were markedly metamorphic. In rhGH group the pathological changes in the ultrastructure of the cells was much less obvious and similar to that in SO group. Conclusion rhGH has significant beneficial effects on protecting intestine mucosa barrier in obstructive jaundice, and reduces intestinal bacteria and endotoxemia translocation.更多还原