急性肝功能衰竭时肠粘膜屏障损伤的研究

Studies on intestinal mucosa barrier injuries in acute hepatic failure

目的：探讨急性肝功能衰竭（简称肝衰）时肠粘膜屏障损伤及其机制，并观察中药大黄对它的防治作用。方法：采用鲨试剂法作血浆内毒素定量，酚一次氨酸法测定谷氨酰胺浓度及荧光法测定谷氨酰胺酶活性和组胺含量，Dans蓝染色法测定肠粘膜通透性。结果：硫代乙酰胺（thioacetamide,TAA)引发大鼠急性肝衰，并伴有严重的肠源性内毒素血症（intestinalendotoxemiaIETM)：肠谷氨酸肢酶活性降低，肠粘膜对谷氨酸胺利用减少，肠粘膜通透性增加。组织细胞学显示，TAA组动物肝细胞发生严重变性坏死；肠粘膜淤血、水肿、糜烂，肠肥大细胞脱颗粒。电镜示肠微绒毛倒伏、脱落，细胞间紧密连接破坏。大黄组动物IETM与肝组织损伤明显减轻。结论：急性肝袁伟有肠粘膜屏障损伤，其发生机制与IETM及其介导的组腹增多有关。大黄对急性肝衰时肠粘膜屏障损伤有一定防治作用。

To ehicidate the mechanism of intestinal muare injuries, as well as the preventive and cure effect ofChinese Medicine Rheum, in acute hepatic failare (AHF) induced by thioaceedde(TAA) METHODS: Endotoxin contentby the Limulus test;glutamine by phcnol-hypochionte method; gluednase activity and histalnine contnt by fluomecence method; intestinal mucosal permeahility by Evans blue method. RESULTS: AHF induced by TAA resulted in intestinalendotoxemia (IETM), reduce of glutaminase activity and glutamine utilization, increase of intestinal mucosal permeability.Histological observation showed that degnerahon, necrosis of liver cells, edema, extravasated blood, erosion and degranulation of the mast cells in intestine mucosa. Electron microscope displayed intestinal microvilli fell off, the tight junction damaged. In Rheum-treated group, the last changes alleviatal. CONCLUSION: Inteshnal mucosa injuries were haportant com-plication in AHF, its tnechbosm was related to IETM and huperhistaminemia. Rheum was effechve for the prevenhon andtherapy of intestinal mucase injdries in AHF.