摘要
目的应用肠系膜上动脉阻断(SMAO)模型,观察抑肽酶在肠缺血-再灌注损伤过程中对肝脏的保护作用。方法24只日本大耳白兔随机平均分为:假手术组(A组),肠系膜上动脉(SMA)不作阻断;缺血-再灌注组(B组);抑肽酶治疗组(C组)。B、C两组采用家兔SMAO模型,阻断时间为45min。C组阻断前5min静注抑肽酶30000kIU/kg,随后以10000kIU·kg-1·h-1维持至实验结束。B、C两组在阻断前(I0)、阻断45min(I1)、再灌注1h(R1)、再灌注2h(R2)时观察血清丙二醛(MDA)、过氧化物歧化酶(SOD)、肿瘤坏死因子α(TNF-α)、磷脂酶A2(PLA2)及肝脏组织形态学变化。A组在相应时点取样检测上述指标。结果(1)C组MDA、TNF-α、PLA2在R2时均明显低于B组(P<0·05),而B组明显高于A组(P<0·05)。(2)C组SOD在R2时明显高于B组(P<0·05)。结论抑肽酶减轻脂质过氧化反应,对肠缺血-再灌注损伤有一定保护作用。血清PLA2和TNF-α的产生和释放减少,可能减轻肠缺血-再灌注过程中对远隔离器官的损害,对肝脏有一定的保护作用。
Objective To observe the protective effect of aprotinin on the intestinal ischemiareperfusion injury in SMAO model. Methods Twenty-four rabbits were randomly divided into three groups（n= 8） ： control group （ A）, ischemia-reperfusion group （B） and aprotinin group （C）. SMAO model was prepared with obstruction time of 45 rain and reperfusion for 2 h. In group C, aprotinin 30 000 kIU/kg was introvenously injected 5 rain before clamping and was infused in a dose of 10 OOO kIU · kg^-1· h^-1. Malondialdehyde（MDA）, supperoxide dismutase （SOD）, tumor necrosis factor-alpha（TNF-α）, phospholipase A2 （ PLA2 ） of serum were measured before obstruction （ I0 ）, at claming for 45 rain （I1） and 1 h （ R1 ）, 2 h （R2） after reperfusion respectively in all three groups. The liver was examined for morphological changes. Results （1） The serum levels of MDA, TNF-α, PLA2 at R2 in group C were significantly lower than those in group B. But the level of group B were markedly higher than those of group A. （2） The level of SOD at R2 in group C was significantly higher than that in group B. （3）The damage of liver tissue in group C was significantly slighter than that in group B under light microscope. Conclusion Aprotinin has protective effects on the intestinal ischemia- reperfusion, reduces the level of lipid peroxidation, and the damage on another organ,such as the liver,secondary to reduction of the level of the PLA2 and TNF-α during the intestinal ischemia-reperfusion.
出处
《临床麻醉学杂志》
CAS
CSCD
2005年第12期835-837,共3页
Journal of Clinical Anesthesiology
