大鼠小肠移植物热缺血再灌注损伤研究

Research on Warm Ischemia/Reperfusion Injury following Small Bowel Transplantation in Rat

目的:探讨大鼠小肠移植物热缺血再灌注损伤后肠黏膜损伤、修复与再生的规律及其参与因素。方法:建立近交系大鼠异位小肠移植热缺血再灌注损伤模型,按热缺血时间0、15、30、60、120min分为5组。分别于移植术后取外周血,测定一氧化氮(NO)、内皮素-1(ET-1)的含量;同期对移植肠标本行常规组织学检查;并观察受体大鼠及移植物的生存率。结果:各组移植物及受鼠7d生存率为100%(6/6)。术后第7天,各热缺血组小肠黏膜组织学评分趋于一致,与非热缺血组之间的差异有统计学意义(P<0.01)。术后第1天ET-1/NO与小肠黏膜组织学评分具有相关性。结论:大鼠小肠移植物在无心跳供体中可以耐受120min的热缺血;热缺血时间对移植术后小肠黏膜修复与再生无明显影响;移植术后早期外周血NO/ET-1失衡可能参与热缺血再灌注损伤。

Objective： To investigate the effects of warm ischemic reperfusion injury in the graft of rat small bowel transplantation. Methods： Heterotopic small bowel transplantation models were established with inbred rats F344. The rats were divided into 5 groups, including 0, 15, 30, 60, 120 min warm ischemia time respectively. The peripheral blood sample was taken to assay nitric oxide （NO） and endothelin-1 （ET-1） on series points of respectively postoperative day （POD） 1, 3 and 7. Simultaneously, small bowel biopsies were gotten for routine histopathological examination. The survival rates of recipient rats and grafts were observed.Results： （1）The one week survival rates of recipient rats and grafts in all groups were 100%. （2）On POD7, there were no apparent differences in mucosal injury among warm ischemia groups. （3）There was a correlation between the ratio of NO/ET-1 and the score of mucosal lesions on POD1. Conclusion： （ 1 ）The graft of rat small bowel transplantation was well tolerated 120 min of warm ischemia in non-heart-beating donor. （2）There is no significant effect on repair and regeneration of grafted small bowel mucosa by increasing warm ischemia time. （3）The disorder of NO/ET-1 may take part in warm ischemia/reperfusion injury.