舒芬太尼预处理对浸水束缚应激糖尿病大鼠胃黏膜损伤指数及髓过氧化物酶的影响

The effect of sufentanil pretreatment on gastric mucosal injury index and myeloperoxidase of diabetic rats by water immersion and restraint stress

目的观察舒芬太尼预处理对浸水束缚应激（water immersion restraint stress，WIRS）糖尿病（diabetic，DM）大鼠急性胃黏膜损伤的影响及可能保护机制。方法急性胃黏膜损害模型采用经典WIRS改良法复制。雄性成年SD大鼠50只，按照随机数字表法分成5组，每组10只：正常对照组（A组），正常大鼠WIRS组（B1组），DM大鼠WIRS组（B2组），舒芬太尼预处理＋B1组（C1组），舒芬太尼预处理＋B2组（C2组）。WIRS大鼠6h后处死取胃组织标本，显微镜下观察胃黏膜损伤指数（gastric mucosal injury index，GI）与组织学改变，比色法测定各组胃组织中髓过氧化物酶（myeloperoxidase，MPO）含量。结果①WIRS 6h后，各组大鼠均发生急性胃黏膜损伤，各组GI值分别为（B1：27．3±4．6，B2：34．6±6．1，C1：3．9±0．9，C2：3．9±0．7），与B1组比较，B2组GI明显升高（P〈0．05），C1组GI显著降低（P〈0．05）；与B2组比较，C2组GI显著减低（P〈0．05）。②与A组比较，B1、B2组MPO值显著升高（P〈0．05）；与B2组比较，C2组MPO值显著减低（P〈0．05）。③光学显微镜下可见大鼠胃黏膜均出现不同程度的充血，水肿，炎性细胞浸润等组织损伤相关的形态学改变，其损伤程度以B2组最为严重，经舒芬太尼预处理后充血，水肿减轻，炎细胞浸润明显减少。④相关分析显示大鼠GI与组织MPO呈正相关（r=0．967，P〈0．01）。结论与正常大鼠比较，DM大鼠更容易发生并加重WIRS所致急性胃黏膜损伤。舒芬太尼预处理可以减轻这种WIRS所致的急性胃黏膜损伤，其机制可能与舒芬太尼对伤害性应激反应的控制以及氧自由基清除增加有关。

Objective To observe the protective role of sulfentanyl pretreatment on acute gastric mucosal lesion induced by water immersion restraint stress （WIRS） in diabetic rats and investigate its＇ possible mechanism. Methods The acute gastric mucosal lesion models were copied by the classic WIRS, Fifty adult SD rats were randomly divided into five groups （n=lO）, including normal rats （group A）, normal rats suffering WIRS （group B1）, diabetic rats suffering WIRSs （group B2）, normal rats suffering WIRS pretreated with sufentanil （group C1 ）, diabetic rats suffering WIRS pretreated with sufentanil （group C2）, all the experimental rates were killed at 6 h after WIRS for stomach samples. Gastric mucosal injury index （GI） was assessed thought lOx dissecting microscope and pathologic histology were observed under optical microscope of each group. Myeloperoxidase （MPO） of gastric tissue homogenate were measured with chromatometry. Results （1） Acute gastric mucosal lesions were found in All rats suffered WIRS. And GI of each group was as follow （B 1 ： 27.3±4.6, B2： 34.6±6.1, C 1 ： 3.9±0.9, C2： 3.9±0.7 ）, GI is significantly higher in group B2 vs. group B1 and C1 （P〈0.05）. （2） There were significantly higher valuer of MPO in group B1 and group B2 vs. group A. （3） It can be found diversity degree of engorgement hydropsia and inflammatory cell infihrate in those rats＇ gastric mucosa 6 h after WIRS,those symptom is wost in group B2 and better in groups which were pretreated with sufentanil. （4） Correlation analysis showed there was a positive correlation between the GI and tissue MPO（r=0.967,P〈0.01 ）. Conclusions The diabetic rats will suffer severer injure of stomach mucous membrane than normal rats. Pretreatment with sufentanil can effectively protect stomach mucous membrane from WIRS-induced injury, and the possible mechanism are the lipid peroxidation depression, oxygen radicals release and neutrophils increase.