生长激素对机械性肠梗阻细菌移位的影响

Effects of Recombinant Human Growth Hormone on Bacterial Translocation Caused by Mechanical Intestinal Obstruction in Rats

目的 :通过应用生长激素后 ,大鼠肠梗阻动物模型细菌移位的改变情况 ,探索可能减少细菌移位的药物。方法 :雄性SD大鼠 30只 ,随机分为假手术组、肠梗阻组和生长激素组。生长激素组每鼠予重组人生长激素 (rhGH) 80 0μg ,腹腔注射 ,每天 1次共 5天 ,最后 1次在术前 2小时。肠梗阻组和生长激素组予结扎回肠 ,造成单纯性机械性肠梗阻模型 ,假手术组作对照。术后 2 4小时处死大鼠 ,采集标本。检测血、肝脏和肠系膜淋巴结 (MLN )细菌移位情况、血浆内毒素水平和进行回肠病理学检查等。结果 :(1)细菌移位率 :假手术组、肠梗阻组和生长激素组分别为 15 %、70 %、和2 0 % (P <0 .0 1)。 (2 )细菌移位数水平 :假手术组、肠梗阻组和生长激素组分别为 874.67± 42 6.5 1CFU/g ,15 41.87±5 2 2 .5 1CFU/g和 895 .0 0± 485 .2 0CFU/g(P <0 .0 5 )。 (3)血浆内毒素水平 :假手术组为 0 .0 5 6± 0 .0 0 3Eu/ml,肠梗阻组为 0 .373± 0 .0 64Eu/ml(P <0 .0 1) ,生长激素组为 0 .0 74± 0 .0 0 2Eu/ml(P <0 .0 1)。 (4 )病理结果显示 ,假手术组肠粘膜基本正常。肠梗阻组粘膜上皮脱落 ,绒毛坏死 ,粘膜下水肿 ,炎症细胞浸润。生长激素组粘膜上皮偶见脱落 ,粘膜下稍水肿 ,未见绒毛坏死。结论

Purpose: The aims of these experiments were to study recombinant human growth hormone (rhGH) on bacterial translocation in rats with mechanical intestinal obstruction. Methods: Thirty Sprague Dawley rats were divided into three group randomly, growth hormone group, rhGH 800 μg/day was given for each rat for five days. Intestinal obstruction group and sham operted group, normal saline 1 ml/day was injected intra abdominally each rat for five days. After this an ileal ligation was performed in growth hormone group and intestinal obstruction group. In sham operated group, a laparotomy was given without ligating the ileum. Twenty four hours later, rats were sacrificed and the mesenteric lymph node (MLN), liver, blood and ileum were harvested. Results: (1)Bacterial translocation rates in sham operated, intestinal obstruction and growth hormone group were 15%, 70% and 20% respectively. The rates in intestinal obstruction group were higher than in sham operated group (P<0.01). The rats in growth hormone group were lower than in intestinal obstruction group (P<0.01). (2)The total population levels of bacteria in sham operated, intestinal obstruction were 874.67±426.51 CFU/g, 1 541.87±522.511 CFU/g and 895.00±485.20 CFU/g respectively. The level in intestinal obstruction group was higher than in sham operated group (P<0.05). The level in growth hormone group was lower than in intestinal obstruction group (P<0.05). (3)Endotoxin levels in sham operated, intestinal obstruction and growth hormone group were 0.056±0.03 Eu/ml, 0.373±0.064 Eu/ml and 0.074±0.002 Eu/ml respectively. Intestinal obstruction group was higher than any other groups and has statistic significance (P<0.01). (4)Pathological results intestinal mucosa in shan operated group was normal. But in intestinal obstruction group, villous necrosis were observed. Epithelial separation and edema, can also be seen. In growth hormone group, slight epithelial separation and edema were found, but villous necrosis was not obsered. Conclusion: (1)The mechanical intestinal obstruction can cause bacterial translocation to mesenteric lymph nodes and liver. (2)rhGH can decrease the bacterial translocation and the level of endotoxin, and can protect intestinal mucosa barrier. It suggest that rhGH may be useful in decreasing bacterial translocation canused by intedstianl obstruction.