小肠移植后肠管早期吸收功能的研究

Study on the absorptive capacity of transplanted small intestine in the early stage in rats

目的探讨小肠移植后早期移植肠管吸收功能状况。方法采用改良的Ｍｏｎｃｈｉｋ法施行大鼠节段性原位小肠移植。分为对照组（ＷｉｓｔｅｒＷｉｓｔｅｒ）和排斥反应组（ＢＮＷｉｓｔｅｒ）。移植后定期测量体重、血糖吸收值及病理组织学检查。结果麦芽糖吸收试验显示各组在移植３０分钟后血糖吸收值明显下降（Ｐ＜０．０５），然后逐渐恢复；急性排斥反应发生时，与对照组相比血糖吸收值明显下降（Ｐ＜０．０５）。病理学检查再灌注后肠管粘膜呈再灌注损伤性改变；急性排斥反应组于移植后４日前与对照组相同，之后逐渐出现粘膜层炎性细胞浸润、肠管淋巴结肿大、结构破坏。结论小肠移植后早期，移植肠管存在着吸收功能，由于再灌注损伤，吸收功能低下。移植后１周左右肠管吸收功能基本上得到恢复。

Objective To establish segmental orthotopic intestinal transplantation models in rats and to study the absorptive capacity of the small intestinal allografts in the early stage of the transplantation. Methods The rats were equally divided into Wister Wister group and BN Wister group. Segmntal orthotopic intestinal transplantation models in rats were developed by using modified Monchik way. The body weight, serum glucose levels were measured, and pathohistological examination performed 30 min, one day and then every 3 days after the transplantation. Results Maltose absorption test showed that the serum glucose level was obviously decreased at the 30 min after transplantation in two groups ( P <0.01), then returned to the normal gradually. At the 4th day of transplantation, the serum glucose level in the BN Wister group was markedly decreased as compared with that in the Wister Wister group ( P <0.05). Pathohistological examinations showed the mucus changes of the re infusion injury in the controls. There were same changes in the BN Wister group in the first 4 days and then inflammatory cells emerged in the intestine mucous which led to the structural destroy of the intestinal mucous. Conclusion The absorptive capacity of the small intestinal allografts may be damaged to some extent but do exist at the early stage of the transplantation. The decreased absorptive capacity was contributed to the reinfusion injury. Maltose absorption test may be considered as a meaningful method to monitor the nutritional function status of the small intestinal allografts.