Sukhotnik Igor, Krausz Michael M, Sabo Edmund, Resnick Murray, Hirsh Mark, Mannheim Dallit, Shiloni Eltan
Rappaport Faculty of Medicine, Technion, Department of Surgery B and Pathology Carmel Medical Center, Haifa, Israel.
Shock. 2003 Jan;19(1):66-70. doi: 10.1097/00024382-200301000-00013.
Sepsis is commonly associated with or complicates short bowel syndrome (SBS). The purpose of the present study was to investigate the effects of endotoxemia on intestinal adaptation in a rat model of SBS. Male Sprague-Dawley rats were divided into three experimental groups: Sham rats underwent bowel transection and re-anastomosis, SBS rats underwent 75% small bowel resection, and SBS-LPS rats underwent bowel resection and were given lipopolysaccharide. Bowel weight, organ weights, and parameters of intestinal adaptation (bowel and mucosal weights, mucosal DNA and protein, villus height, and crypt depth) were determined on day 15 following operation. The results of this study demonstrate that SBS rats showed a significant increase (vs. Sham) in jejunal and ileal bowel and mucosal weight, mucosal DNA and protein, villus height, and crypt depth. SBS-LPS animals demonstrated lower (vs. SBS rats) final body weight (215 +/- 7 vs. 287 +/- 10 g, P < 0.05), overall weight in duodenum (98+/- 2 vs. 119 +/-5 mg/cm, P < 0.05) and jejunum (144 +/- 9 vs. 189 +/- 16 mg/cm, P < 0.05), mucosal weight in jejunum (54 +/- 5 vs. 69 +/- 5 mg/cm, P < 0.05) and ileum (31 +/- 2 vs. 37 +/- 3 mg/cm, P < 0.05), mucosal DNA in jejunum (89 +/- 11 vs. 120 +/- 11 microg/cm, P < 0.05) and ileum (46 +/- 6 vs. 61 +/- 4 microg/cm, P < 0.05), jejunal crypt depth (152 +/- 19 vs. 189 +/- 12 microm, P < 0.05), and ileal villus height (405 +/- 63 vs. 515 +/- 30 pm, P < 0.05). In addition, the SBS group had no late (second week) mortality, whereas the SBS-LPS group had an 17% late mortality rate. In conclusion, in a rat model of SBS-LPS, endotoxemia appears to inhibit structural intestinal adaptation and increase mortality.
脓毒症常与短肠综合征(SBS)相关或使其复杂化。本研究的目的是在SBS大鼠模型中研究内毒素血症对肠道适应性的影响。雄性Sprague-Dawley大鼠被分为三个实验组:假手术组大鼠接受肠横断和再吻合术,SBS组大鼠接受75%小肠切除术,SBS-LPS组大鼠接受肠切除术后给予脂多糖。在术后第15天测定肠重量、器官重量以及肠道适应性参数(肠和黏膜重量、黏膜DNA和蛋白质、绒毛高度和隐窝深度)。本研究结果表明,SBS组大鼠空肠和回肠的肠及黏膜重量、黏膜DNA和蛋白质、绒毛高度和隐窝深度较假手术组有显著增加。SBS-LPS组动物的最终体重(215±7 vs. 287±10 g,P<0.05)、十二指肠总重量(98±2 vs. 119±5 mg/cm,P<0.05)和空肠总重量(144±9 vs. 189±16 mg/cm,P<0.05)、空肠黏膜重量(54±5 vs. 69±5 mg/cm,P<0.05)和回肠黏膜重量(31±2 vs. 37±3 mg/cm,P<0.05)、空肠黏膜DNA(89±11 vs. 120±11 μg/cm,P<0.05)和回肠黏膜DNA(46±6 vs. 61±4 μg/cm,P<0.05)、空肠隐窝深度(152±19 vs. 189±12 μm,P<0.05)以及回肠绒毛高度(405±63 vs. 515±30 pm,P<0.05)均较低。此外,SBS组无晚期(第二周)死亡率,但SBS-LPS组有17%的晚期死亡率。总之,在SBS-LPS大鼠模型中,内毒素血症似乎会抑制肠道结构适应性并增加死亡率。