创伤应激下肠粘膜通透性的改变

Intestinal permeability in patients after trauma

目的 :研究腹部大手术作为一种创伤应激对肠粘膜通透性的影响。 方法 :前瞻、随机选取胃肠道肿瘤患者 4 0例 ,分别于术前 1天、术后 7天测定口服含乳果糖 10g、甘露醇 5g的测试液 ,测定 6h尿中乳果糖和甘露醇比值 (L/M)的变化 ,用高效液相色谱法测定尿中乳果糖和甘露醇的浓度 ,并以 2 0例健康成人作为正常对照。 结果 :2 0例健康志愿者L/M比值为 0 .0 2 8± 0 .0 10 ,4 0例患者术前L/M比值为 0 .0 2 5± 0 .0 0 2 ,与 2 0例健康对照组比无明显差异 (P >0 .0 5 ) ;术后第 7天L/M比值为 0 .0 70± 0 .0 0 4 ,比术前明显增高 (P <0 .0 1)。 结论

Objectives:To study the intestinal permeability(IP) following surgical trauma. Methods:Forty patients underwent abdominal surgery were enrolled in the study. Lactulose/mannitol test was performed on the day before operation(POD 1) and the 7th day after operation(POD+7). Ten g of lactulose and 5 g of mannitol were given, urine was collected for 6 hours. Twenty healthy volunteers acted as control. Results:L/M ratio of control group was 0.028±0.010, and the test group were 0.025± 0.002 and 0.070±0.004 on POD 1 and POD+7 respectively. No significant difference of L/M ratios were found between test group on POD 1 and controls, while elevated L/M ratios were found on POD+7 versus POD 1. Conclusions: L/M ratio is increased in the early period of surgical trauma.