Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
Biosci Rep. 2018 Jan 10;38(1). doi: 10.1042/BSR20170931. Print 2018 Feb 28.
Some patients with intra-abdominal infection (IAI) may develop intra-abdominal hypertension (IAH) during treatment. The present study investigated the impact of IAI combined with IAH on the intestinal mucosal barrier in a rabbit model. Forty-eight New Zealand white rabbits were randomly divided into four groups: (i) IAI and IAH; (ii) IAI alone; (iii) IAH alone; and (iv) Control group. IAI model: cecal ligation and puncture for 48 h; IAH model: raised intra-abdominal pressure (IAP) of 20 mmHg for 4 h. Pathological changes in intestinal mucosa were confirmed by light and scanning electron microscopy. FITC-conjugated dextran (FITC-dextran) by gavage was used to measure intestinal mucosal permeability in plasma. Endotoxin, d-Lactate, and diamine oxidase (DAO) in plasma were measured to determine intestinal mucosal damage. Malonaldehyde (MDA), superoxide dismutase (SOD), and GSH in ileum tissues were measured to evaluate intestinal mucosal oxidation and reducing state. Histopathologic scores were significantly higher in the IAI and IAH group, followed by IAI alone, IAH alone, and the control group. FITC-dextran, d-Lactate, DAO, and endotoxin in plasma and MDA in ileum tissues had similar trends. GSH and SOD were significantly lowest the in IAI and IAH group. Occludin levels were lowest in the ileums of the IAI and IAH group. All differences were statistically significant (-values <0.001). IAI combined with IAH aggravates damage of the intestinal mucosal barrier in a rabbit model. The combined effects were significantly more severe compared with a single factor. IAI combined with IAH should be prevented and treated effectively.
一些腹腔感染（IAI）患者在治疗过程中可能会发展为腹腔内高压（IAH）。本研究旨在探讨兔腹腔感染合并腹腔高压（IAH）模型对肠黏膜屏障的影响。将 48 只新西兰大白兔随机分为四组：（i）IAI+IAH 组；（ii）IAI 组；（iii）IAH 组；（iv）对照组。IAI 模型：盲肠结扎穿孔 48 h；IAH 模型：升高腹内压（IAP）至 20 mmHg 持续 4 h。光镜和扫描电镜观察肠黏膜病理变化。灌胃荧光素标记葡聚糖（FITC-dextran），检测血浆中肠黏膜通透性。检测血浆内毒素、D-乳酸和二胺氧化酶（DAO）以评估肠黏膜损伤。检测回肠组织丙二醛（MDA）、超氧化物歧化酶（SOD）和谷胱甘肽（GSH）以评估肠黏膜氧化和还原状态。IAI+IAH 组的组织病理评分最高，其次为 IAI 组、IAH 组和对照组。血浆中 FITC-dextran、D-乳酸、DAO、内毒素和回肠组织中 MDA 的变化趋势相似。IAI+IAH 组的 GSH 和 SOD 最低。IAI+IAH 组回肠组织中的紧密连接蛋白（occludin）水平最低。所有差异均有统计学意义（-值<0.001）。IAI 合并 IAH 加重了兔腹腔感染合并腹腔高压模型的肠黏膜屏障损伤，其联合作用明显比单一因素更严重。IAI 合并 IAH 应得到有效预防和治疗。
