Ersoy Ömer Faik, Özkan Namık, Özsoy Zeki, Kayaoğlu Hüseyin Ayhan, Yenidoğan Erdinç, Çelik Alper, Özuğurlu Aziz Fikret, Arabacı Çakır Ebru, Lortlar Neşe
Department of General Surgery, Gaziosmanpasa University Faculty of Medicine, Tokat-Turkey.
Department of Biochemistry, Gaziosmanpasa University Faculty of Medicine, Tokat-Turkey.
Ulus Travma Acil Cerrahi Derg. 2016 Jul;22(4):315-21. doi: 10.5505/tjtes.2015.49465.
The present objective was to identify effects of early melatonin application on healing of anastomotic wound and inflammation in an experimental sepsis model.
A total of 60 Wistar albino rats were divided into 2 groups. Cecal ligation puncture (CLP) and colonic resection anastomosis were performed on both the control group and the melatonin treatment group. Both groups were divided into 3 subgroups consisting of 10 rats each. One subgroup from each group underwent re-laparotomy at the 16th hour, the next on the 3rd day, and the final subgroup on the 7th day. Presently evaluated were effects of melatonin treatment of early sepsis on interleukin-6 (IL-6), interleukin-10 (IL-10), interferon gamma (INF-γ), and C-reactive protein (CRP) levels, as well as burst pressures (BPs), collagen and hydroxyproline (OHP) content of the anastomotic segments, histopathologic healing, immunohistochemical expressions, CD34, and transforming growth factor beta (TGF-ß).
IL-6 and INF-γ levels of the treatment group showed a significant decrease at the 16th hour and an increase on the 3rd and 7th postoperative days. IL-10 levels were significantly higher at the 16th hour and significantly lower on the 3rd and 7th postoperative days in the control group (p<0.001 for each). The treatment group also showed significantly higher capillary permeability, fibroblast proliferation, and collagen deposits (p<0.001 for each). CD34 expression was significantly increased in the treatment group on the 7th postoperative day (p=0.005).
Application of melatonin in early sepsis significantly improved colonic anastomotic healing in a rat model.
本研究旨在确定在实验性脓毒症模型中早期应用褪黑素对吻合口伤口愈合及炎症的影响。
将60只Wistar白化大鼠分为2组。对照组和褪黑素治疗组均进行盲肠结扎穿刺（CLP）及结肠切除吻合术。两组再各自分为3个亚组，每组10只大鼠。每组中的一个亚组在第16小时进行再次剖腹手术，下一个亚组在第3天进行，最后一个亚组在第7天进行。目前评估了早期脓毒症的褪黑素治疗对白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、干扰素γ（INF-γ）和C反应蛋白（CRP）水平的影响，以及吻合段的爆破压力（BP）、胶原蛋白和羟脯氨酸（OHP）含量、组织病理学愈合、免疫组化表达、CD34和转化生长因子β（TGF-β）。
治疗组的IL-6和INF-γ水平在第16小时显著降低，在术后第3天和第7天升高。对照组的IL-10水平在第16小时显著升高，在术后第3天和第7天显著降低（每组p<0.001）。治疗组还显示出显著更高的毛细血管通透性、成纤维细胞增殖和胶原蛋白沉积（每组p<0.001）。治疗组在术后第7天CD34表达显著增加（p = 0.005）。
在大鼠模型中，早期脓毒症时应用褪黑素可显著改善结肠吻合口愈合。
