淤血后处理对大鼠小肠淤血再灌注损伤保护作用的实验研究

目的研究门静脉淤血后处理对小肠黏膜淤血再灌注损伤的保护作用。 方法将24只雄性SD大鼠随机分为假手术组（Sham组）、淤血损伤组（CR组）、淤血后处理组（CPO组），各8只。Sham组仅行开关腹手术；CR组通过阻断门静脉45 min，再灌注60 min制作小肠淤血再灌注损伤模型；CPO组在再灌注时行开放30 s/夹闭30 s，3个循环淤血后处理。模型制作后60 min后抽取门静脉血检测血清肿瘤坏死因子α（TNF-α）及内毒素水平，取距回盲部约10 cm的近端小肠组织行病理组织学检查和水肿程度分析。 结果（1） Sham组、CR组、CPO组大鼠门静脉血清TNF-α质量浓度分别（31.37±2.39）、（114.75±7.46）、（89.37±5.83）μg/L，内毒素质量浓度分别为（0.64±0.16）、（5.04±0.28）、（4.00±0.31）EU/ml，三组血清TNF-α、内毒素的质量浓度比较，CR组较Sham组显著增高，CPO组较CR组显著降低，差异均有统计学意义（F=404.84、680.85，均P<0.01）。（2） CR组的小肠组织病理损伤邱氏评分为4.01±0.35，显著高于Sham组的0.43±0.21和CPO组的3.58±0.34（Z=6.18、4.25，均P<0.01）。（3） CR组的小肠组织湿干比为5.29±0.36，显著高于Sham组的3.34±0.23和CPO组的4.26±0.26 （F=2.03、0.44，P=0.003、0.012）。 结论淤血后处理对小肠黏膜的淤血再灌注损伤具有保护作用，其保护机制可能是延缓并减少炎性介质释放。

Study on the protective effect of congestion postconditioning on acute intestinal venous congestionreperfusion injury in rats

ObjectiveTo evaluate the effects of congestion postconditioning on acute intestinal venous congestion reperfusion injury in rats. MethodsA total of twenty-four male Sprague-Dawley (SD) rats were randomly assigned to three groups: the acute intestinal venous congestion reperfusion group (CR group, n=8), the congestion postconditioning group (CPO group, n=8) and the sham group (Sham group, n=8). In CR group, portal vein was clamped for 45 min, then reperfusion for 60 min to induce intestinal congestion reperfusion injury. In CPO group, the same procedure plus postconditioning (portal vein was open for 30 s, then clamped for 30 s with three cycles of this procedure) initiated immediately at the onset of portal vein reperfusion. In Sham group, all the procedures were the same as CR group except for clamping portal vein. After reperfusion ileum samples were collected for Chiu’s scores and wet-to-dry weight. The blood of portal vein was collected for detection of TNF-α and endotoxin in serum. Results(1) The serum concentrations of TNF-α in the portal vein of rats in the Sham, CR, and CPO groups were (31.37±2.39), (114.75±7.46), (89.37±5.83) μg/L, and the endotoxin concentrations were (0.64±0.16), (5.04±0.28) and (4.00±0.31) EU/ml, respectively. The serum concentrations of TNF-α and endotoxin were significantly higher in the CR group than in the Sham group. The CPO group was significantly lower than the CR group. The differences were statistically significant (F=404.84, 680.85, both P<0.01). (2) The pathological lesions of the small bowel in the CR group had Qiu score of 4.01±0.35, which was significantly higher than 0.43±0.21 of the Sham group and 3.58±0.34 of CPO group (Z=6.18, 4.25, both P<0.01). (3) In the CR group, the wet to dry ratio of the small intestine was 5.29±0.36, which was significantly higher than 3.34±0.23 of the Sham group and 4.26±0.26 of CPO group (F=2.03, 0.44, P=0.003, 0.012). ConclusionCongestion postconditioning has protective effects on congestion and reperfusion injury of small intestinal mucosa, and its protective mechanism may be to delay and reduce the release of inflammatory mediators.