体外循环对肠黏膜屏障功能影响的研究进展

肠黏膜屏障功能是指正常肠道具有较为完善的功能隔离带,体外循环特殊的循环方式常引起肠道黏膜灌注不足、血液与管道接触产生的炎症反应、肠道缺血再灌注等使其屏障功能受损引发肠道细菌/内毒素移位,导致术后感染甚至发生全身炎症反应( SIRS)和多器官功能不全综合症(MODS).肠道是全身应激反应的靶器官,又是SIRS和MODS的发动机,体外循环如何影响肠道屏障功能及如何调控体外循环期间的肠道屏障功能,降低细菌、内毒素移位,现就其机制及影响因素进行综合阐述,为临床提供依据.

PROGRESSION OF CARDIOPULMONARY BYPASS(CPB) EFFECTS ON INTESTINAL MUCOSAL BARRIER FUNCTION

It ’s observed that CPB plays a role in intestinal mucosal barrier function through three ways,including perfusion of intestinal mucosal is low,the contact between blood and the extracorporeal circuit with oxygenators activate the complement and coagulation system,followed by production of proinflammatory and damage of ischemia/reperfusion.The factors of CPB effects on intestinal mucosal barrier function,which include the perfusion of intestinal mucosal,systemic inflammation response to CPB,temperature,anesthesia,damage of ischemia/reperfusion,drugs,and so on.These effects of CPB are closely associated with systemic inflammation response or multiple organ dysfunctions.We summarize the relation between CPB and the mechanism.