肠道部分缺血-再灌注损伤诱发多器官功能障碍综合征的实验研究

The study of multiple organ dysfunction syndrome(MODS) induced by partial ischemia and reperfusion of intestine

目的 复制肠道部分缺血 -再灌注 (ischemiareperfusion ,I/R)损伤诱发多器官功能障碍综合征(MODS)的动物模型。方法 大耳白兔 5 0只 ,分为失血性休克组、肠部分I/R组和假手术对照三组。根据失血性休克组肠系膜上动脉 (SMA)血流量的变化 ,用自行设计的血流阻断器阻断SMA血流量 5 0 %～ 70 % ,维持 4h ,制作肠道部分缺血 再灌注损伤动物模型 ,观察脏器功能、炎症反应以及病理形态学的改变。结果 肠部分I/R组 ,伤后 2 4hALT、Cr、CK MB、肿瘤坏死因子 (TNF α)水平显著升高 ,心、肝、肺等均显示严重病理学损害 ,动物 72h死亡率 4 0 % ,MODS发生率 5 5 %。结论 本模型在致伤因素、器官功能、病理形态、发病率和死亡率等方面均符合MODS模型的标准 。

Objective To replicate an animal model of multiple organ dysfunciton syndrome(MODS)induced by partial ischemia of intestine,and to explore its mechanism.Methods Fifty white rabbits were randomly divided into 3 groups:sham operation group,ischemia and reperfusion(I/R) group,and hemorrhagic shock groups.The superior mesenteric artery(SMA)was partially occluded with a self-designed obturator to decrease SMA blood flow to 50% to 70%.The blood levels of GPT,Cr,CK-MB and TNF-α were measured from 0 h to 3days.The pathologic changes in different organs were also examed scales.Results When the SMA blood flow was reduced to(50.69±1.81)%,the levels of TNF-α,Cr,GPT,CK-MB increased dramatically.Severe pathological changes were observed in the heart,liver,and kidney.The mortality was 40%,and the incidence rate of MODS was 55%.Conclusion The etiological factor,the changes in organ funcitons,the pathological changes in different organs,the morbidity and mortality rates conform closely to early MODS after shock.The model can be used in further study of post-traumatic MODS.