摘要
目的对高原缺氧所致的急性胃肠道黏膜损伤及其机制进行探讨。方法对20例由平原急进高原个体分别于进入高原前1天、进入高原第3天和第7天进行胃镜检查,并同步抽取血液标本,对其胃肠动力激素胃动素(moti-lin,MTL)、血管活性肠肽(vasoactive intestinal peptide,VIP)、P物质(substance P,SP)、胰高血糖素样肽(glucagon-likepeptide,GLP-1),炎症介子白细胞介素1(interleukin-1,IL-1)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumornecrosis factor-alpha,TNF-α)、血小板活化因子(platelet activating factor,PAF)及自由基丙二醛(malondialdehyde,MDA)、过氧化氢(hydrogen peroxide,H2O2)的含量进行检测。结果 20例急性缺氧个体进入高原第3天及第7天胃肠动力激素、炎症介质及氧自由基均出现显著改变,且均以第3天最为显著,其中胃肠动力激素VIP、GLP-1及炎症介质IL-1、IL-6、TNF-α、PAF、氧自由基MDA、H2O2显著升高,MTL、SP显著降低(第3天P<0.01,第7天除MDAP>0.05外,其余P<0.05)。胃镜检查阳性例数分别为17例(约85%)和10例(50%),与进入高原前比较均具有统计学差异(P<0.01),其中蠕动缓慢、胆汁返流及黏膜损伤分别高达60%、50%和85%,黏膜损伤主要表现有出血、充血、淤血、糜烂、溃疡及胆汁返流等。结论高原急性缺氧可导致急进高原个体急性胃肠道黏膜损伤,其损伤机制主要包括:胃肠道运动紊乱,炎症反应及氧自由基的损伤。
Objective To investigate the acute injury of gastrointestinal mucosa caused by acute hypobaric hypoxia and its mechanism. Methods Twenty people who immediately entered into plateau accepted gastroscope examination one day before and 3, 7 days after entering into plateau. Blood was sampled to detecte the content of motilin （MTL）, vasoactive intestinal peptide （VIP）, glucagon-like peptide （GLP-1）, gastrin, substance P （SP）, interleukin-1 （IL-1）, interleukin-6 （IL-6）, tumor necrosis factor alpha （TNF-α）, platelet activating factor （PAF）, malondialdehyde （MDA） and hydrogen peroxide （H2O2）. Results In all the 20 people, there were significant decrease of MTL and SP, and significant increase of IL-1, IL-6, TNF-α, PAF, MDA and H2O2 at 3 days （P0.01） and 7 days （P0.05 except MDA） after hypoxia expose. There were 17 （85%） and 10 （50%） positive cases of gastroscope examination respectively, higher than before hypoxia expose （P0.01）, including slow wriggling of stomach （60%）, bile refluxing （50%） and mucosa alteration （85%）. The main manifestations of mucosa injury were bleeding, congestion, erosion, ulcer and bile refluxing. Conclusion Acute hypobaric hypoxia can cause significant damage of gastrointestinal mucosa. The underlying mechanism includes gastrointestinal motility disorder, inflammation reaction and oxyradical damage.
出处
《华南国防医学杂志》
CAS
2011年第1期4-7,共4页
Military Medical Journal of South China
关键词
高原
急性缺氧
胃肠动力激素
炎症介质
氧自由基
胃肠黏膜损伤
Plateau
Acute hypoxia
Gastrointestinal motility hormones
Inflammation mediators
Oxyradical
Gastrointestinal mucosa injury
