肝细胞生长因子对移植小肠通透性及细菌易位的作用

EFFECT OF HEPATOCYTE GROWTH FACTOR ON INTESTINAL PERMEABILITY AND BACTERIAL TRANSLOCATION AFTER SMALL BOWEL TRANSPLANTATION IN RAT

目的探讨肝细胞生长因子(hepatocyte growth factor,HGF)对移植小肠通透性及细菌易位的作用。方法以Wistar大鼠20只为受体,SD大鼠20只为供体行异位全小肠移植,并以环孢素A(6mg/kg.d)肌注抑制排斥反应。HGF组(n=10)用微量输液泵持续均匀输入HGF(150μg/kg.d),对照组(n=10)输入等量生理盐水,随机选取同批正常Wistar大鼠作为正常基准(n=10)。第7天两组实验动物均分别以乳果糖/甘露醇液2ml(含乳果糖100mg、甘露醇50mg)行移植小肠灌注,采集24h尿液检测乳果糖、甘露醇含量及乳果糖/甘露醇比值;第8天采集移植小肠肠系膜淋巴结及门静脉血行细菌培养,小肠组织学观察。结果对照组尿液中乳果糖含量为0.0931%±0.0085%,乳果糖/甘露醇比值为0.132±0.021,与正常基准0.0150%±0.0020%和0.020±0.005比较,差异均有统计学意义(P<0.05);HGF组乳果糖含量为0.0396%±0.0090%,乳果糖/甘露醇比值为0.056±0.013,与正常基准比较差异均有统计学意义(P<0.05),且低于对照组(P<0.05)。HGF组移植小肠肠系膜淋巴结细菌阳性率为10%,对照组为60%,差异有统计学意义(P<0.05)。HGF组门静脉血细菌阳性率为10%,对照组为20%,差异无统计学意义(P>0.05)。两组移植小肠组织学观察仅见少量炎性细胞浸润。结论HGF能够降低同种移植小肠的通透性及细菌易位率,改善小肠黏膜屏障功能。

Objective To evaluate the effect of hepatocyte growth factor（HGF） on intestinal permeability and bacterial translocation after small bowel transplantation in rats. Methods Twenty Wistar rats were as recptors and twenty SD rats as donors. After heterotopic intestinal grafting, cyclosporine A was administered at 6 mg/kg · day intramuscularly for inhibiting rejection. The SD rats were divided into 2 groups （n= 10）. HGF was administered at 150 μg/kg· day （HGF group） and normal saline was administered at 150 μg/kg · day （control group）. Intestinal permeability and bacterial translocation to the mesenteric lymph nodes and portal vein were assessed at the 8th postoperative day. Results The lactulose and lactulose/ mannitol of control group （0. 093 1%± 0. 008 5% and 0. 132±0. 021） were higher than those of normal reference value （0. 015 0%± 0. 002 0% and 0. 020 ± 0. 005） （P〈 0.05）. The lactulose and lactulose/ mannitol of HGF group （0. 039 6%± 0. 009 0% and 0. 056± 0. 013） were also higher than those of normal reference value（P〈0.05）. The bacterial culture positive proportion of lymphaden in HGF group and control group were 10% and 60%, showing statistically significant difference （P〈 0.05）. The bacterial culture positive proportion of portal vein in HGF group and control group were 10% and 20% respectively（P〉0.05）. Conclusion HGF can decrease intestinal permeability and bacterial translocation from the lumen of the graft to the mesenteric lymph nodes, thus improve gut barrier function, may be of help to reduce the incidence of septic complications after intestinal grafting.