原位肝移植大鼠肠道微生态状况研究

目的 探讨肝移植术后大鼠肠道微生态的变化.方法 将雄性Brown-Norway(BN)大鼠40只随机分成肝移植组(BN→BN,n=16,共8对)、模拟移植组(n=8)、假手术组(n=8)和对照组(n=8),24 h后处死,分析肠道菌群构成、回肠末端超微结构变化、血浆内毒素水平以及细菌易位至肝、脾、肾和肠系膜淋巴结的比例.结果 肝移植术后24 h存在明显的肠道菌群紊乱,表现为肠杆菌科细菌和肠球菌数量增加(P<0.05),乳杆菌和双歧杆菌数量下降(P<0.05),移植组与模拟移植组存在肠黏膜上皮细胞微绒毛的损伤;肝移植组血浆内毒素水平升高(P<0.01),细菌易位至肝脏、脾脏和肠系膜淋巴结的阳性率增加(P值均<0.05);与模拟移植组比较,肝移植组细菌易位至肝脏的阳性率增加(P<0.05).结论 肝移植术后存在一定程度的肠道微生态紊乱和肠道屏障功能损伤,可能与肝移植手术过程中所经历的缺血再灌注过程有关.

The change of intestinal microecology in rats after orthotopic liver transplantation

Objective To investigate the intestinal microflora status and bacterial translocation in rats after liver transplantation. Methods Male Brown-Norway (BN) rats were randomly divided into 4 groups : group Ⅰ (n=8) for liver transplantation; group Ⅱ (n=8) for simulated liver transplantation; group Ⅲ (n=8) for sham operation and group Ⅳ (n=8) for normal group. Caecal bacterial counts, plasma endotoxin, intestinal mucesal ultrastructure and bacterial translocation to liver, spleen, kidney, and mesenteric lymph node were studied 24 h after surgery. Results The numbers of Bifidobacterium and Lactobacillus per gram of wet feces were significandy decreased in group Ⅰ compare with those in the group Ⅲ and group Ⅳ, while Enterobacteriaceae and Enterocecus counts were increased markedly compare with those in the group Ⅲ and group Ⅳ, but no different was found between group Ⅰ and group Ⅱ. Impaired intestinal mucesa integrity were found in the group Ⅰ and group Ⅱ. In group Ⅰ,the levels of plasma endotoxin increased after the transplantation when compare with group Ⅲ and group Ⅳ. Increased incidence of bacterial translocation to liver, spleen and mesenteric lymph node were also observed after the transplantation(compare with those in the group Ⅳ,P <0. 01 ;compare with those in the group Ⅲ,P <0.01,P <0. 01 ,P <0. 05 ,separately). The increased rate of the bacterial translocation in liver was also found in transplantation group as compare with group Ⅱ(P<0.05). Conclusions Liver transplantation may lead to disturbance of intestinal microflora and impairment of intestinal mucosal barrier function, and this dysfunction might be caused by the process of intestinal ischemia-reperfusion injury in transplantation.