失血性休克再灌注对早期肠黏膜显微结构的影响

目的观察失血性休克再灌注后肠黏膜屏障功能损伤及其病理改变和超微结构变化。方法16只家兔随机分为2组（n=8）：假手术组（A），休克再灌注组（B）。采用失血性休克再灌注模型。检测灌注后0．5、2、4h血清磷脂酶A2（PLA2）、一氧化氮（NO）和丙二醛（MDA）值；实验结束后取回肠末端黏膜测MDA和组织钙含量；分别通过光镜和电镜观察肠黏膜结构的变化。结果B组血清NO相对A组降低明显。而PLA2、MDA显著升高。B组肠黏膜MDA和组织钙含量有明显升高（P〈0．05）；光镜和电镜观察表明B组肠黏膜损伤明显重于A组。结论失血性休克再灌注使肠道经历缺血缺氧和再灌注损伤，导致肠黏膜生理结构被破坏。

Effect on intestinal mucosal ultrastructure in the early stage of reperfusion after hemorrhagic shock

Objective To observe disruption of gut barrier and pathologic and ultrastructural change of intestinal mucosa after hemorrhagic shock-reperfusion.Method Sixteen white rabbits were divided randomly into 2 groups(n=8 each):Control group(A),Shock group(B).By using the model of hemorrhagic shock/reperfusion,serum PLA_2,NO and malondialdehyde(MDA) were determined at(0.5th,)2th,4th h after reperfusion.After the experiment,MDA and Ca~(2 ) contents of intestinal mucosa were determined,and the mucosal structure was observed under light and electronic microscopes.Results In comparison with group A,serum NO in group B was significantly lower,and MDA and PLA_2 were markedly higher.MDA and Ca~(2 ) contents of intestinal mucosa in group B were significantly higher(P<0.05).Under light and electronic microscopes,in comparison with group A,intestinal mucosa damage in group was more serious.Conclusion Hemorrhage-shock-induced intestinal ischemia-reperfusion can cause disruption of intestinal mucosal structure.