Okay Erdem, Karadenizli Aynur, Müezzinoglu Bahar, Zeybek Umit, Arzu Ergen H, Isbir Turgay
Department of General Surgery, Kocaeli University School of Medicine, Derince/Kocaeli, Turkey.
J Surg Res. 2005 Aug;127(2):164-70. doi: 10.1016/j.jss.2005.02.012. Epub 2005 Apr 15.
Translocating enteric bacteria have been suggested as playing a major role in the development of infections after partial hepatectomy. We investigated the effect of N-acetylcysteine (NAC) on bacterial translocation (BT) and intestinal mucosa as the first line of defense against BT.
We compared four groups of eight Sprague-Dawley male rats each: sham, control (partially hepatectomized), partial hepatectomy plus preoperative single-dose NAC, and a fourth that received partial hepatectomy with a preoperative single-dose NAC plus treatment with NAC for 2 days. Microorganism counts of tissues, lung injury score, lung tissue glutathione, and malondialdehyde levels and microscopy of intestinal mucosa were studied at the end of 48 h.
Microorganism count in the lung and mesenteric lymph node cultures and lung injury score were significantly higher in the control group when compared with the sham, third, and fourth groups (lung: 9919.6 versus 0.0, 2912.9, 1550.0 cfu/g tissue; mesenteric lymph nodes: 8458.3 versus 0.0, 89.0, 88.9 cfu/g tissue; lung injury score: 3.25 versus 0.5, 1.13, 1.75). In the control group, the villous height of the distal ileal mucosa was significantly shorter than the sham group (65.25 versus 75.25 microm) and the difference from groups 3 and 4 was not statistically significant. Neutrophil infiltration in the distal ileal mucosa of the control group was significantly higher than the sham, third and fourth groups (3.13 versus 0.25, 0.38 and 1.0).
The parenteral use of NAC attenuates bacterial translocation after partial hepatectomy in rats. Attenuation of the lung injury after partial hepatectomy in NAC-treated groups might be attributable to both anti-inflammatory effect and the effect on BT.
移位性肠道细菌被认为在部分肝切除术后感染的发生中起主要作用。我们研究了N-乙酰半胱氨酸（NAC）对细菌移位（BT）以及作为抵御BT第一道防线的肠黏膜的影响。
我们将四组每组8只雄性Sprague-Dawley大鼠进行比较：假手术组、对照组（部分肝切除）、部分肝切除加术前单剂量NAC组，以及第四组，该组接受部分肝切除并术前单剂量NAC加NAC治疗2天。在48小时结束时，研究组织中的微生物计数、肺损伤评分、肺组织谷胱甘肽和丙二醛水平以及肠黏膜显微镜检查。
与假手术组、第三组和第四组相比，对照组肺和肠系膜淋巴结培养物中的微生物计数以及肺损伤评分显著更高（肺：9919.6对0.0、2912.9、1550.0 cfu/g组织；肠系膜淋巴结：8458.3对0.0、89.0、88.9 cfu/g组织；肺损伤评分：3.25对0.5、1.13、1.75）。在对照组中，回肠远端黏膜的绒毛高度显著短于假手术组（65.25对75.25微米），与第三组和第四组的差异无统计学意义。对照组回肠远端黏膜中的中性粒细胞浸润显著高于假手术组、第三组和第四组（3.13对0.25、0.38和1.0）。
大鼠部分肝切除术后胃肠外使用NAC可减轻细菌移位。NAC治疗组部分肝切除术后肺损伤的减轻可能归因于抗炎作用和对BT的作用。
