缺血性脑卒中大鼠肠黏膜的损害及小肠运动功能障碍

Change of Intestinal Motility and Intestinal Mucosal Impairment in Rats with Cerebral Arterial Thrombosis

目的观察缺血性脑卒中大鼠肠黏膜形态学改变及小肠动力变化,探讨二者之间的关系。方法 48只雄性健康Wistar大鼠分为2组,假手术对照组和缺血性脑卒中模型组,模型组又根据实验终止时间分为5个亚组,每组动物8只。采用改良的Longa线栓法建立大鼠大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型。分别于缺血后3h、6h、12h、24h、48h进行光镜及电镜下小肠黏膜病理变化的研究以及利用亚甲蓝染色法检测小肠推进比。结果 MCAO组的小肠推进比与对照组相比显著减低,差异有统计学意义(P<0.05),3h组与6h组比较差异有统计学意义(P<0.01),6h组与12h组、12h组与24h组、24h组与48h组之间比较差异无统计学意义。光镜下MCAO组术后6h即可见肠绒毛肿胀、增粗、缩短,24h见绒毛顶端破损、剥脱,固有层裸露,对照组肠黏膜结构基本完整。电镜下MCAO组小肠绒毛上皮细胞内可见线粒体肿胀、嵴断裂,细胞器空泡变性,细胞间紧密连接增宽,可见凋亡细胞。结论缺血性脑卒中后可出现肠黏膜损伤和小肠动力障碍,二者的发生发展可能互为因果。

Objective To determine the change of intestinal mucosa,intestinal motility and their relationship. Methods Forty-eight Wistar rats were randomly divided into control group（n=8） and middle cerebral artery occlusion（MCAO） group（n=40）. MCAO group was further divided into 3 h,6 h,12 h,24 h,48 h after the cerebral arterial thrombosis,each subgroup had 8 rats. Along with the application of transluminal techniques of Longa to create the focal cerebral ischemia model in rats. The damages of intestinal mucosa were observed under light and electron microscopy and determine the intestinal motility at each special time point using the methylene blue staining method. Results There was significant difference in the intestinal motility between control and MCAO groups（P0.05）. There was statistical significance of difference between 3 h group and 6 h group（P0.01）,and there was no statistical significance of difference between 6 h group and 12 h group,12 h group and 24 h group,24 h group and 48 h group（P0.05）. Damage of intestinal mucosa could be demonstrated via pathological analysis,such as,engorgement,thickening,decurtation,denudation and so on. Conclusion After cerebral arterial thrombosis,damages of intestinal mucosa and intestinal dyskinesis may occur,the above two may be cause and effect for each other.