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血管变化在窒息新生仔猪坏死性小肠结肠炎的发病机制中起作用。

Vascular changes play a role in the pathogenesis of necrotizing enterocolitis in asphyxiated newborn pigs.

作者信息

Gellén B, Kovács J, Németh L, Németh P, Vágvölgyi J, Bari F, Megyeri P, Pintér S, Temesvári P, Deli M A, Vecsernyés M, Szilvássy Z, Koltai M, Abrahám C S

机构信息

Department of Paediatrics, University of Szeged, Korányi fasor 14-15, 6720 Szeged, Hungary.

出版信息

Pediatr Surg Int. 2003 Jul;19(5):380-4. doi: 10.1007/s00383-003-1015-4. Epub 2003 May 20.

Abstract

Necrotizing enterocolitis (NEC) is the most common acquired gastrointestinal emergency in neonates. We have developed an animal model of NEC in asphyxiated newborn pigs and investigated the effects of asphyxia on blood flow in superior mesenteric artery and abdominal aorta, cardiovascular data, arterial acid-base and blood gas parameters, and endothelial cytoskeletal structure in mesenteric microvasculature. Anesthetized, mechanically ventilated newborn pigs were included in two groups: piglets underwent severe asphyxia, and sham-operated control animals. A cardiovascular and metabolic failure developed in asphyxiated piglets approximately 1 h after the induction: severe hypotension and bradyarrhythmia were seen and significant reductions of the blood flow were measured in the superior mesenteric artery and abdominal aorta during the critical phase. Rearrangement of cytoskeletal actin structure corresponding to enhanced vascular permeability was seen with bodipy phallacidin in mesenterial endothelium of asphyxiated piglets after a 24-h recovery period. In conclusion, severe vasomotor changes during asphyxia may result in mesenteric endothelial dysfunction implicated in increased vascular permeability, edema formation, and development of NEC in asphyxiated piglets.

摘要

坏死性小肠结肠炎(NEC)是新生儿最常见的后天性胃肠道急症。我们建立了窒息新生猪的NEC动物模型,并研究了窒息对肠系膜上动脉和腹主动脉血流、心血管数据、动脉酸碱和血气参数以及肠系膜微血管内皮细胞骨架结构的影响。将麻醉并机械通气的新生猪分为两组:经历严重窒息的仔猪和假手术对照动物。窒息仔猪在诱导后约1小时出现心血管和代谢衰竭:出现严重低血压和缓慢性心律失常,在关键期测量到肠系膜上动脉和腹主动脉血流显著减少。在恢复24小时后,用硼二吡咯亚甲基鬼笔环肽观察到窒息仔猪肠系膜内皮细胞中细胞骨架肌动蛋白结构重排,这与血管通透性增强相对应。总之,窒息期间严重的血管舒缩变化可能导致肠系膜内皮功能障碍,这与窒息仔猪血管通透性增加、水肿形成和NEC的发生有关。

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