胰酶在创伤/失血性休克后肠损伤中的作用

目的 通过观察胰蛋白酶抑制剂ANGD的作用,分析胰酶与创伤/失血性休克(T/HS)后肠损伤的关系。方法 雄性SD大鼠剖腹术(创伤)后分别经肠腔或静脉内给予ANGD或生理盐水,随后经受T/HS或创伤/假休克(T/SS),90min后林格液复苏;复苏后3h评估肠损伤情况。结果 肠腔内给予ANGD的T/HS大鼠肠绒毛损伤明显少于肠腔内无ANGD灌注及静脉给予ANGD的T/HS对照组。肠腔内灌注林格氏液与不行肠腔内灌注相比,对T/HS所致的肠损伤显示出某种程度的保护作用。结论 肠腔内的胰蛋白酶可能是T/HS后肠损伤的重要促进因素。

Role of pancreatic enzymes in gut injury secondary to trauma/hemorrhagic shock in rats

Objective To test the hypothesis that pancreatic digestive enzymes are involved in trauma/hemorrhagic shock (T/HS)-induced intestinal injury. Methods Male Sprague-Dawley rats were given pancreatic enzyme inhibitor (6-amidino-2 -naphthyl p-guanidinobenzoate dimethanesulfonate, ANGD) intraluminally or intravenously after laparotomy (trauma), and then subjected to 90 min of hemorrhagic shock or sham shock. Intestinal injury was assessed 3 h after resuscitation with Ringer's lactate solution. Results Histological analysis demonstrated fewer injured villi in shock rats with intraluminal ANGD treatment than in those with intravenous ANGD administration and control shock rats. Furthermore, intestinal intraluminal perfusion of Ringer's lactate solution without ANGD produced a certain degree of protection against T/HS-induced intestinal injury, as compared with the rats without perfusion. Conclusion Pancreatic proteolytic enzymes in ischemic gut may serve as important toxic factors contributing to gut injury following T/HS.