阻塞性黄疸大鼠肠黏膜屏障功能变化及力肽的治疗作用

目的探讨阻塞性黄疸大鼠肠黏膜屏障功能变化以及力肽的治疗作用。方法将36只Wistar大鼠随机分成胆管结扎组（BDL）、假性手术组（SL）、胆管结扎＋力肽治疗组（Dipeptiven）3组，分别于术后24h、72h、1周和2周测定血浆内毒素值（Endotoxin，ET），并于2周后作细菌移位率和肠黏膜组织学检查。结果BDL组厌氧菌移位阳性率（58．33％）及各时间点血浆ET值显著高于SL组（0）和Dipeptiven组（8．33％）（P〈0．01），Dipeptiven组在各时间点血浆ET值较BDL组显著降低（P〈0．01）。组织学检查显示，BDL组肠黏膜发生了实质性损害。结论阻塞性黄疸时肠黏膜屏障损害可能促进肠道细菌移位，导致感染易感性增高。而力肽可改善受损小肠黏膜结构及减轻肠道细菌移位。

Changes in intestinal mucosal barrier function and therapeutic effects of Dipeptiven in rats with experimental obstructive jaundice

Objective To study the changes in intestinal mucosal barrier function and the therapeutic effects of Dipeptiven in rats with obstructive jaundice.Methods Thirty-six Wistar rats were randomly divided into 3 groups:SL group,BDL group and Dipeptiven group.The plasma levels of endotoxin(ET)were determined at 24 h,72 h,1 week and 2 weeks.The incidence of bacillic translocation and intestinal mucosa pathological changes were examined at 2 weeks.Results The incidence of anaerobic bacilli translocation(58.33%)and ET levels at all time points were significantly higher in the BDL group than in the Slgroups(0)and Dipeptiven group(8.33%)(P<0.01).ET levels in Dipeptiven group were decreased significantly as compared with those in BDL group(P<0.01).Histological examination revealed the injury of intestinal mucosa in BDL group.Conclusion The intestinal mucosa barrier injury in obstructive jaundice may promote bacterial translocation,resulting in the increased susceptibility to infection.Dipeptiven can improve the injuried intestine mucosal stucture and decrease the bacterial translocation.