大鼠结肠黏膜电切术后抗菌治疗对局部组织修复的影响

目的：监测结缔组织生长因子（CTGF）、表皮生长因子受体（EGF-R）在电切术后的结肠黏膜损伤创面组织修复过程中的变化,观察抗生素盐酸左氧氟沙星、甲硝唑的运用对这一过程的影响。方法：将SD大鼠分为正常组、手术未治疗组、假手术组和手术治疗组,分别于术后第4、7、12天取结肠溃疡局部组织,用免疫组化法测定CTGF、EGF-R的表达。结果：①正常组的CTGF和EGF-R阳性染色主要在结肠黏膜层单层柱状上皮细胞的胞浆,其他各组除此之外,CTGF的阳性染色还出现在黏膜下层的结缔组织的成纤维细胞胞浆中;EGF-R出现在黏膜层杯状细胞的胞浆及黏膜下层的血管内皮细胞胞浆中。②手术治疗组CTGF和EGF-R的IOD值均在术后第4天最高,以后逐渐降低;而假手术组和手术未治疗组在术后第12天最高,且手术未治疗组高于假手术组。③手术治疗组的CTGF的IOD值在术后第7天降至正常水平,而EGF-R在术后第12天降至正常水平。结论：在大鼠结肠黏膜电切术后,机体自身的黏膜修复反应可能在术后第7天内无明显反应,盐酸左氧氟沙星及甲硝唑可使结缔组织和上皮组织的修复时间明显提前,抗菌治疗有助于创面的愈合。

The effects of two antibiotics in colonic mucosa repair of rat with mucosa electrocision

Objective： To investigate the effect of Levofloxacin Hydrochloride and Metronidazole on the changes of CTGF、EGF-R in mucosa of rat colon electrocision wound.Methods： Rats were divided into normal control group,untreated group,sham group and treated group randomly.On the 4th day,7th day,and 12th day after operation,IOD of CTGF and EGF-R was determined by immunohistochemistry（SABC） in the colonic tissue samples around the mucosa electrocision wound of all animals.Results： ①The positive stain of CTGF and EGF-R mainly located in the endochylema of superficial epithelium of colonic mucosa in normal control group.Less and weaker positive stain of CTGF was observed additionally in desmocyte′s endochylema of submucosa,and the endochylema of goblet cell and vascular endothelial cell in subnatant mucosa also appeared positive stain of EGF-R in other groups.②IOD of CTGF and EGF-R was highest on the 4th day,and latter gradually dropped in treated group;that in sham group and untreated group was highest on the 12th day,that in untreated group was higher than that in sham group.③The IOD of CTGF in treated group dropped to the normal level on the 7th day after operation（P〈0.05）,but IOD of EGF-R dropped to normal level on the 12th day after operation（P〈0.05）.Conclusion： The reaction of mucosa repair after the electroresection of mucosa is obscure on the 7th day after operation,and then this reaction becomes stronger and stronger from 7th day to 12th day.Levofloxacin Hydrochloride and Metronidazole might promote tissue repair in the mucosa electricision wound.