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[卡巴胆碱肠内给药对肠道部分缺血/再灌注损伤所致全身炎症反应和多器官功能障碍的影响]

[Enteral administration of carbachol on systemic inflammatory response and multiple organ dysfunction induced by partial ischemia/reperfusion injury to the gut].

作者信息

Hu Sen, Cao Wei-Hong, Sun Dan, Lu Yi, Bai Yu-Mei, Sheng Zhi-Yong

机构信息

Department of Burns and Plastic Surgery, Burns Institute, 304th Clinical Department of General Hospital of PLA, Beijing 100037, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2005 Jan;17(1):49-52.

Abstract

OBJECTIVE

To study the effects of enteral administration of carbachol on organ dysfunction induced by partial ischemia/reperfusion injury to the intestine.

METHODS

Seventy-five white rabbits were randomized into four groups: ischemia/reperfusion (I/R), carbachol+ I/R and sham operation. The superior mesenteric artery (SMA) was partially blocked with self-designed blocker, producing 50% decrease in SMA blood flow, lasting for 4 hours. One hour after SMA occlusion, carbachol was injected into gut in carbachol+I/R group. Sham group was treated as same as I/R group except without SMA occlusion. The levels of alanine aminotransferase (ALT), creatinine (Cr), MB isoenzyme of creatine kinase (CK-MB) and tumor-necrosis factor-alpha (TNF-alpha) were measured by automatic analyzer and with radio-immunology method before SMA occlusion, and at 2, 4, 6, 8, 24, 48 and 72 hours after occlusion. The pathological changes of the intestinal tissue were observed with hematoxylin and eosin stained sections.

RESULTS

In I/R groups, the levels of TNF-alpha, Cr, ALT, CK-MB in plasma were increased dramatically after partial ischemia/reperfusion injury to the gut. Severe pathological changes were observed in the hearts, livers, and kidneys. While in carbachol treatment groups, the levels of TNF-alpha, Cr, ALT, CK-MB in plasma were decreased dramatically after enteral administration of carbachol during ischemia stage. The pathological injuries were alleviated in the heart, liver, and kidney.

CONCLUSION

Enteral administration of carbachol may alleviate after the systemic inflammatory response and pathological changes in various organs, thus provide a protective effect on gut and remote organs partial ischemia/reperfusion of the intestine.

摘要

目的

研究肠内给予卡巴胆碱对部分小肠缺血/再灌注损伤所致器官功能障碍的影响。

方法

75只白兔随机分为四组:缺血/再灌注组(I/R)、卡巴胆碱+缺血/再灌注组和假手术组。用自行设计的阻断器部分阻断肠系膜上动脉(SMA),使SMA血流量降低50%,持续4小时。在SMA阻断1小时后,向卡巴胆碱+缺血/再灌注组的肠道内注射卡巴胆碱。假手术组除不进行SMA阻断外,处理同缺血/再灌注组。在SMA阻断前以及阻断后2、4、6、8、24、48和72小时,用自动分析仪和放射免疫法测定丙氨酸转氨酶(ALT)、肌酐(Cr)、肌酸激酶MB同工酶(CK-MB)和肿瘤坏死因子-α(TNF-α)的水平。用苏木精-伊红染色切片观察肠组织的病理变化。

结果

在缺血/再灌注组中,肠道部分缺血/再灌注损伤后,血浆中TNF-α、Cr、ALT、CK-MB水平显著升高。心脏、肝脏和肾脏出现严重病理变化。而在卡巴胆碱治疗组中,缺血期肠内给予卡巴胆碱后,血浆中TNF-α、Cr、ALT、CK-MB水平显著降低。心脏、肝脏和肾脏的病理损伤减轻。

结论

肠内给予卡巴胆碱可减轻全身炎症反应及各器官的病理变化,从而对肠道及远处器官的部分小肠缺血/再灌注起到保护作用。

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