肠梗阻大鼠小肠黏膜屏障功能变化的实验研究

The experimental study on alteration of intestinal mucosal barrier function in rats with intestinal obstruction

目的：探讨大鼠肠梗阻时肠黏膜屏障功能的动态变化。方法建立急性完全性小肠梗阻模型，按肠梗阻时间不同进行分组，采血测定血清二胺氧化酶（DAO）的活性和肠型脂肪酸结合蛋白（IFABP）的浓度，取肠系膜淋巴结鉴定细菌移位的发生率并观察小肠组织病理变化。结果肠梗阻12 h后血清IFABP浓度开始升高，随着肠梗阻时间的推移，血清IFABP浓度值逐渐上升，与肠黏膜损伤程度变化趋势一致，两者呈正相关关系（r＝0．841，P＜0．01）。肠梗阻24 h后血清DAO活性升高，至48 h后达峰值，随后下降。大鼠肠梗阻48 h后才开始发生肠系膜淋巴结细菌移位，明显高于假手术组（P＜0．01）。结论肠梗阻早期就发生肠黏膜屏障功能损害，细菌移位滞后于血清生物学指标改变。肠型脂肪酸结合蛋白浓度变化可用来判断肠黏膜损伤程度的生物学指标，为肠梗阻严重并发症的防治和预后评估提供有益的参考和实验依据。

Objective To investigate the dynamic changes of the intestinal barrier function in rats after in-testinal obstruction .Methods The rats model of intestinal obstruction was established and samples of tissue ,mesen-teric lymph nodes and serum were collected at different intervals .The serum diamine oxidase （ DAO） and intestinal fatty acid binding protein（IFABP） were determined,the gut tissue was examined microscopically and the incidence of bacterial translocation was identified by mesenteric lymph nodes .Results The serum concentration of IFABP began to increase at 12h,and increased gradually with the passage of time of intestinal obstruction .In addition,it was noted that there was a significant positive correlation between the serum concentration of IFABP and the degree of intestinal mucosa change（r=0.841,P〈0.01）.DAO activity increased after 24h of intestinal obstruction,up to the peak at 48h and declined by followed time .The mesenteric lymph node bacterial translocation began to arise after 48h,which was significantly higher than the sham-operated group（P〈0.01）.Conclusion The intestinal barrier was damaged dur-ing early stage of intestinal obstruction .The occurrence of bacterial translocation is obviously slower than the change of serum biological indicators .It was found that serum IFABP can reflect the degree of intestinal barrier injury , which contributes to judging the course of disease and preventing the complications after intestinal obstruction .