免疫调理对大鼠弥漫性脑损伤后肠屏障功能的影响

Effect of immunomodulation on intestinal barrier function after diffuse brain injury in rats

目的观察免疫调理对弥漫性脑损伤后肠屏障的影响,探讨其对肠屏障的保护作用。方法采用Marmarou方法复制成年雄性Wistar大鼠弥漫性脑损伤模型,致伤并复苏存活的大鼠按处理方法不同分为模型组、乌司他丁(UTI)组,另以只切开头皮不致伤的大鼠为对照组。分别于伤后3、6、12、24、48 h进行指标监测,观察血液中肠屏障受损指标[二胺氧化酶(DAO)]、促炎因子(TNF-α)及抗炎因子(IL-10)水平,光镜下观察小肠组织绒毛高度的改变。结果模型组及UTI组的血浆DAO含量较对照组明显升高,肠绒毛高度则明显降低,分别于伤后6 h及3 h开始差异均具有统计学意义(P<0.05)。随时间推移UTI组DAO含量较模型组有明显下降趋势,肠绒毛高度则表现为明显升高趋势,二者分别于12 h及24 h后开始显现差异性(P<0.05)。UTI组及模型组的TNF-α水平和IL-10水平较对照组差异有统计学意义,UTI组及模型组的TNF-α水平均为先升高后降低的趋势,但UTI组较模型组下降更明显;而IL-10水平则较模型组高,差异均有统计学意义(P<0.05),以早期增高更明显。结论 UTI可下调弥漫性脑损伤大鼠的血TNF-α水平、升高IL-10水平,减轻炎症反应,促进肠黏膜修复,且在创伤早期即显现出免疫调理作用。

Objective To investigate the effect of immune conditioning on intestinal barrier after diffuse brain injury(FBI),and its protective effect on intestinal barrier.Methods The FBI model of adult male Wistar rats was reproduced by marmarmarou method.The injured and resuscitated rats were divided into model group,ulinastatin(UTI)group in addition,the rats with only the scalp incision without injury were used as the control group.The levels of diamine oxidase(DAO),tumor necrosis factor(TNF)-αand interleukin(IL)-10 were observed at 3,6,12,24 and 48 hours after injury,and the changes of intestinal villi height were observed under light microscope.Results Compared with the control group,the plasma DAO content in the model group and UTI group was significantly higher,while the height of intestinal villi was significantly lower.The difference was statistically significant at 6 hours and 3 hours after injury,respectively(P<0.05).Compared with the model group,the DAO content in UTI group decreased significantly with time coursing,while the villus height increased significantly.The difference between the two groups began to appear after 12 hours in DAO and 24 hours in villus height(P<0.05).The level of TNF-αand IL-10 in UTI group and model group were significantly higher than those in the control group,but the UTI group decreased more significantly than the model group,while the IL-10 level of UTI group was higher than that of model group(all P<0.05).Conclusion Ulinastatin can reduce the level of TNF-αin blood,increase the level of IL-10,reduce the inflammatory response,promote the repair of intestinal mucosa,and show the immunomodulatory effect in the early stage of trauma.