ADH活性对绞窄性肠梗阻大鼠早期肠缺血预测作用

THE VALUE OF ALCOHOL DEHYDROGENASE ACTIVITY IN PREDICTING EARLY ISCHEMIA OF INTESTINE OF STRANGULATED INTESTINAL OBSTRUCTION IN RATS

目的探讨乙醇脱氢酶（ADH）活性对绞窄性肠梗阻大鼠早期肠缺血的预测作用。方法成年健康Wistar大鼠72只，随机分为假手术组（A组，n=8），单纯性肠梗阻（S组，n=32），绞窄性肠梗阻组（I组，n=32）。A组仅开腹翻动肠管后关腹；S组在盲肠末端以上10cm处结扎小肠；I组结扎肠系膜上动脉根部。S、I组分别于造模成功后O．5、1．0、3．0、6.0h下腔静脉取血测定血清乙醇脱氢酶（ADH）、天冬氨酸氨基转氨酶（AST）、丙氨酸转氨酶（ALT）水平，并与肝、小肠损伤病理评分做相关性分析。结果I组各时间点ADH活性与A组比较差异均有显著性（F=37．27，q=5．53～16．31，P＜0．05）；S组与I组各对应时间点ADH活性比较差异均有显著性（q：5．025～12．20，P＜0.05）；S组各时间点各指标与A组比较差异均无显著性（F=15．24～37．27，P＞0．05）；与A组比较，I组ALT、AST分别在6．0h和3．0h明显升高，差异有显著意义（F=15．24、16．69，q=12．32、12．81，P＜O．05）。I组ADH、AI。T、AST与小肠、肝脏病理评分均呈正相关（r=O．696～0．795，P＜0．05）。结论ADH水平在绞窄性肠梗阻早期即开始升高，与肠损伤程度呈正相关，可能成为预测早期肠绞窄的指标。

Objective To investigate the predictive value of alcohol dehydrogenase （ADH） activity for early diagnosis of strangulated intestinal obstruction （SIO） in rats. Methods Seventy-two adult Wistar rats were randomized to three groups as group A （sham operation group, n=8）, group S （simple intestinal obstruction, n=32）, and group I （strangulated intestinal obstruction group n=32）. In group A, only the abdomen was opened and closed; in group S, simple obstruction was created by ligating the ileal segment, 10 cm proximal to the cecum; and in group I, the base of superior mesenteric artery was ligated. At hours 0.5, 1.0, 3.0 and 6.0 after completion of model creation, vena cava sampling was done in the experimental rats for detecting serum ADH, aspartate aminotransferase （AST） and alanine aminotransferase （ALT） and their correlation with injury scores of intestine and liver was analyzed. Results The difference of ADH between group A and group I of each time point was significant （F = 37.27,q=5.53-16.31 ,P〈0.05） ; and that between group S and group I was significant as well （q=5.025-12.20,P〈0.05） ; the difference of ADtt between group A and group S of each time point was not significant （F=15.2-37.27, P〉0.05）. Compared with group A, the levels of ALT and AST in group I at 6.0h and 3.0h elevated （F=l5.24,16.69;q=12.32,12.811P〈O.05）. The ADH, ALT and AST in group I were positively correlated with injury scores of small intestine and liver （r = 0.696- 0.795, P〈0.05）. Conclusion ADH level starts to elevate in the early stage of strangulated intestinal obstruction, showing a positive correlation with the degree of intestinal damage, which may become a potential marker for predicting early strangulation of bowel.