淤血后处理对小肠黏膜淤血再灌注损伤保护作用研究

Protective effect of congestion post-conditioning on acute intestinal venous congestion reperfusion injury in rats

目的探讨门静脉淤血后处理对小肠黏膜淤血再灌注损伤的保护作用。方法将24只SD大鼠随机分为假手术组(Sham组,n=8)、淤血损伤组(CR组,n=8)和淤血后处理组(CPO组,n=8)。Sham组仅行开关腹手术;CR组通过阻断门静脉45 min,再灌注1 h制作小肠淤血再灌注损伤模型;CPO组在再灌注时行开放30 s/夹闭30 s,3个循环淤血后处理。再灌注1 h后,抽取3组大鼠的门静脉血,检测肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)及白细胞介素-6(IL-6)水平;取距回盲部约10 cm的近端小肠组织行病理组织学检查,测定肠道组织中丙二醛(MDA)含量及超氧化物歧化酶(SOD)的活性。结果 Sham组、CR组和CPO组小肠组织病理损伤邱氏评分分别为(0. 43±0. 21)分、(4. 01±0. 35)分和(3. 58±0. 34)分,3组间两两比较,差异均有统计学意义(P <0. 05)。CR组和CPO组小肠组织MDA含量明显高于Sham组,且CR组MDA含量低于CPO组,组间比较,差异均有统计学意义(P <0. 05)。CR组和CPO组小肠组织SOD含量明显低于Sham组,且CR组SOD含量低于CPO组,组间比较,差异均有统计学意义(P <0. 05)。CR组和CPO组门静脉血TNF-α、IL-1β及IL-6浓度明显高于Sham组,且CR组TNF-α、IL-1β及IL-6浓度均高于CPO组,组间比较,差异均有统计学意义(P <0. 05)。结论淤血后处理对小肠黏膜的淤血再灌注损伤具有保护作用,其机制可能为淤血后处理增加了内源性抗氧化剂的活性,减轻组织脂质过氧化程度。

Objective To investigate the protective effect of postoperative portal vein congestion on small intestinal mucosal reperfusion injury and to investigate its protective mechanism.Methods A total of SD rates were randomly divided into the sham operation group（Sham group, n =8）,congestion injury group（CR group, n =8）and post-congestion group（CPO group, n =8）.Rats in the Sham group only had a switch abdominal surgery;rats in the CR group were performed a small intestine congestion reperfusion injury model which were made by blocking the portal vein for 45 minutes and reperfusion for 1 hour;rats in the CPO group were opened for 30 seconds/clamping for 30 seconds during reperfusion,and 3 cycles of post-fusion treatment.After 60 minutes of reperfusion,portal vein blood was taken to detect the levels of TNF-α,IL-1β and IL-6.The proximal small intestine tissue was taken from the ileocecal area about 10 cm for histopathological examination.The contents of MDA and SOD were determined.Results Qiu′s score of small intestinal tissue injury in the Sham group,CR group and CPO group was （0.43±0.21）,（4.01±0.35）and （3.58±0.34）,respectively,and the difference was statistically significant（ P 〈0.05）.MDA content in small intestine of CR group and CPO group was significantly higher than that of Sham group,and MDA content in CR group was lower than that in CPO group.The difference was statistically significant（ P 〈0.05）.SOD content in small intestine of CR group and CPO group was significantly lower than that of Sham group,and SOD content in CR group was lower than that in CPO group,and the difference was statistically significant（ P 〈0.05）.The concentrations of TNF-α,IL-1βand IL-6 in portal blood of CR group and CPO group were significantly higher than those of Sham group,and the concentrations of TNF-α,IL-1β and IL-6 in CR group were all higher than those of CPO group,and the differences were statistically significant（ P 〈0.05）.Conclusion Post-congestion treatment has protective effect on the reperfusion injury of small intestinal mucosa.The protective mechanism may be to increase the activity of SOD in endogenous antioxidants and reduce the degree of lipid peroxidation in tissues.