Villa Xavier, Kuluz John W, Schleien Charles L, Thompson John F
Department of Pediatrics, University of Miami School of Medicine, Miami, FL, USA.
Crit Care Med. 2002 Jul;30(7):1576-80. doi: 10.1097/00003246-200207000-00030.
To measure the effect of pre-ischemic administration of intraluminal epidermal growth factor on the changes in intestinal permeability induced by 30 mins of superior mesenteric artery occlusion, followed by 2 hrs of reperfusion.
Prospective, randomized, placebo-controlled experimental study.
University basic science research laboratory.
Healthy, young, adult, male Sprague-Dawley rats.
A 10-cm segment of small intestine was isolated and studied in situ in rats that were anesthetized with fentanyl and mechanically ventilated. Intestinal ischemia-reperfusion injury was induced by temporary occlusion of the superior mesenteric artery for 30 mins, followed by 2 hrs of reperfusion. Three groups were studied: time controls with a sham operation, saline-treated ischemia-reperfusion, and epidermal growth factor-treated ischemia-reperfusion. Epidermal growth factor, 100 ng/min, was infused intraluminally, beginning 30 mins before and continued until 40 mins after ischemia.
Intestinal permeability was measured for each 10-min time period by using chromium-labeled EDTA. Histopathologic injury was assessed by light microscopy. After superior mesenteric artery occlusion, intestinal permeability increased approximately ten-fold and was sustained for 2 hrs of reperfusion in saline-treated rats. Pretreatment with epidermal growth factor significantly reduced the permeability changes during reperfusion by >60% compared with saline-treated animals (p <.05). Histopathologic sections revealed apparently more extensive loss of epithelial cells and mucosal disruption in saline-treated intestine compared with epidermal growth factor-treated intestine.
Pre-ischemic administration of intraluminal epidermal growth factor significantly protects against intestinal ischemia-reperfusion injury.
测定缺血前腔内给予表皮生长因子对肠系膜上动脉闭塞30分钟后再灌注2小时所诱导的肠通透性变化的影响。
前瞻性、随机、安慰剂对照实验研究。
大学基础科学研究实验室。
健康、年轻、成年雄性Sprague-Dawley大鼠。
分离一段10厘米长的小肠,在经芬太尼麻醉并机械通气的大鼠原位进行研究。通过暂时闭塞肠系膜上动脉30分钟,随后再灌注2小时来诱导肠缺血-再灌注损伤。研究了三组:假手术时间对照组、生理盐水处理的缺血-再灌注组和表皮生长因子处理的缺血-再灌注组。在缺血前30分钟开始腔内输注表皮生长因子,剂量为100 ng/分钟,并持续至缺血后40分钟。
使用铬标记的乙二胺四乙酸(EDTA)每隔10分钟测量一次肠通透性。通过光学显微镜评估组织病理学损伤。在肠系膜上动脉闭塞后,生理盐水处理的大鼠肠通透性增加了约10倍,并在再灌注2小时内持续存在。与生理盐水处理的动物相比,表皮生长因子预处理显著降低了再灌注期间的通透性变化>60%(p<.05)。组织病理学切片显示,与表皮生长因子处理的肠相比,生理盐水处理的肠上皮细胞明显更广泛地丢失,黏膜破坏更严重。
缺血前腔内给予表皮生长因子可显著预防肠缺血-再灌注损伤。