Silva Marcia A C P, de Meirelles Luciana R, Bustorff-Silva Joaquim M
Division of Pediatric Surgery, State University of Campinas Medical School.
J Pediatr Surg. 2007 Jun;42(6):1062-5. doi: 10.1016/j.jpedsurg.2005.07.009.
BACKGROUND/PURPOSE: Early histologic changes induced by intestinal ischemia-reperfusion injury (IIRI) have been extensively studied using animal models. However, information regarding late effects on intestinal motility is lacking. The aim of this study was to investigate the late effects of IIRI on myenteric plexus histology and intestinal motility.
Thirty-two postweaning male rats weighing between 58 and 103 g were divided randomly into 4 groups: Control (unoperated), Sham (celiotomy), 30-minute ischemia (celiotomy and superior mesenteric artery ischemia for 30 minutes), and 45-minute ischemia (celiotomy and superior mesenteric artery ischemia for 45 minutes). Postoperative intestinal motility was assessed by weighing total fecal output for 24 hours on the 3rd, 7th, 14th, and 21st day after surgery. Segments of duodenum, jejunum, and ileum were examined at light microscopy for changes in the myenteric plexus.
Three weeks after IIRI, the ganglion cells from the myenteric plexus appeared in light microscopy, spongy or foamy, containing many vacuoles in their cytoplasm. The neuronal nucleus became irregular, with degenerative signs. These alterations did not occur among animals from the control or sham groups. Although the animals of the 45-minute ischemia group showed a significant drop in fecal output in the 21st postoperative day, this appeared to have no effect on weight gain.
The results suggest that intestinal ischemia-reperfusion causes late neuronal damage. These changes resulted in alterations of intestinal motility, which, within the conditions of the present study, had no repercussion on general weight gain.
背景/目的:肠道缺血再灌注损伤(IIRI)诱导的早期组织学变化已通过动物模型进行了广泛研究。然而,关于其对肠道运动后期影响的信息却很缺乏。本研究的目的是调查IIRI对肠肌丛组织学和肠道运动的后期影响。
32只断奶后体重在58至103克之间的雄性大鼠被随机分为4组:对照组(未手术)、假手术组(剖腹术)、30分钟缺血组(剖腹术和肠系膜上动脉缺血30分钟)和45分钟缺血组(剖腹术和肠系膜上动脉缺血45分钟)。术后第3、7、14和21天,通过称量24小时总粪便输出量来评估肠道运动。对十二指肠、空肠和回肠段进行光学显微镜检查,以观察肠肌丛的变化。
IIRI三周后,光学显微镜下可见肠肌丛的神经节细胞呈海绵状或泡沫状,细胞质中含有许多空泡。神经元细胞核变得不规则,出现退行性体征。对照组或假手术组的动物未出现这些改变。虽然45分钟缺血组的动物在术后第21天粪便输出量显著下降,但这似乎对体重增加没有影响。
结果表明肠道缺血再灌注会导致后期神经元损伤。这些变化导致肠道运动改变,但在本研究条件下,对总体重增加没有影响。