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脾切除对重度热伤诱导的大鼠肠黏膜屏障破坏的影响
引用本文:柳向东,李卫,黎明,陈振勇. 脾切除对重度热伤诱导的大鼠肠黏膜屏障破坏的影响[J]. 复旦学报(医学版), 2013, 40(1): 63-67
作者姓名:柳向东  李卫  黎明  陈振勇
作者单位:1复旦大学附属金山医院烧伤整形外科上海200540; 2华中科技大学同济医学院附属协和医院普外科 武汉430030
摘    要: 目的 研究脾切除对重度热伤大鼠肠黏膜屏障的影响。方法 80只Wistar大鼠,随机分成对照组、热伤组(B组),热伤+脾切除7 天组(B+SP7组)和热伤+脾切除14 天组(B+SP14组)。对照组置于25℃水浴;热伤组于92℃水浴造成30% III度烫伤;热伤+脾切除组在热伤同时行脾切除,分别于伤后7 天及14天抽血后处死。检测血清内毒素、核因子κB(nuclear factor κB,NF-κB)和肿瘤坏死因子 α(tumor necrosis factor α,TNF-α)含量;病理图像分析仪观察末端回肠的形态学变化,并采用Western blot法检测小肠黏膜上皮紧密连接蛋白 1 (zonula occludens 1,ZO-1)和闭锁蛋白(occludin)的表达。结果 B组大鼠血清内毒素[(1.071±0.29 ) EU/mL]、NF-κB [(125±14.1) pg/mL]和TNF-α [(99.1±18.1) μg/mL]含量较对照组分别上升301%、247%和608% (P<0.01),B+SP7组较对照组分别增加226%、168%和370%,差异有统计学意义(P<0.01)。B+SP14组仅血清TNF α较对照组上升445%,上升幅度高于7天组(P<0.01)。形态学上热伤组小肠黏膜明显萎缩,平均肠绒毛高度和黏膜厚度较对照组下降明显(P<0.01)。切除脾脏7 天和14 天后,平均肠绒毛高度和黏膜厚度的下降幅度小于热伤组(P<0.01)。用图像采集系统定量分析Western blot条带的相对光密度值,热伤后ZO-1(0.56±0.17)和闭锁蛋白(1.30±0.27)均明显下降(P<0.01);相对于对照组,B+SP7组的下降幅度小于热伤组(均P<0.01),B+SP14组仅闭锁蛋白的下降幅度小于B+SP7组。结论 严重热伤损伤小肠黏膜屏障,脾切除后短期内由于其释放的细胞因子减少,无脾动物肠黏膜上皮细胞紧密连接蛋白表达恢复,肠屏障的损害减轻。

关 键 词:热损伤    细胞因子  紧密连接蛋白  肠黏膜屏障  大鼠

Splenectomy attenuates sever thermal trauma-induced intestinal barrier breakdown in rats
LIU Xiang-dong , LI Wei , LI Ming , CHEN Zhen-yong. Splenectomy attenuates sever thermal trauma-induced intestinal barrier breakdown in rats[J]. Fudan University Journal of Medical Sciences, 2013, 40(1): 63-67
Authors:LIU Xiang-dong    LI Wei    LI Ming    CHEN Zhen-yong
Affiliation:1Department of Plastic and Burn Surgery,Jinshan Hospital,Fudan University,Shanghai 200540,China;2Department of General Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei Province,China
Abstract:Objective To investigate the effects of splenectomy on severe thermal trauma induced intestinal barrier breakdown in rats.Methods Eighty Wistar rats were randomly divided into four groups equally as control,burn,burn+splenectomy 7 days (B+SP7) and burn+splenectomy 14 days (B+SP14).After operation 7 days and 14 days,the serum endotoxin levels,nuclear factor κB (NF-κB) and tumor necrosis factor α (TNF-α) were assayed.Small segments of terminal ileum mucosa were taken for the determination of morphological analysis with image analysis system,and the expression of tight junction protein 1 (ZO-1) and occludin were analyzed by Western blot.Results Compared with control group,burn group significantly increased in serum endotoxin levels [(1.071±0.29 ) EU/mL,NF-κB (125±14.1) pg/mL,and TNF-α(99.1±18.1) μg/mL],which were 301%,247% and 608% higher than those in control group (all P<0.01).While the values in B+SP7 group rose 226%,168% and 370% than those in control group (all P<0.01).But in B+ SP14 group,only serum TNF-α increased significantly (445%,P<0.01),which was higher than in B+SP7 group (P<0.01).Morphometricly the intestinal mucosa became obvious atrophy in burn group,the average intestinal villus height and mucosal thickness were decreased significantly (P<0.01).After splenectomy 7 days or 14 days,the extents of average intestinal villus height and mucosal thickness were less than those in burn group (P<0.01).The relative optical density of Western blot images were significantly decreased on ZO-1 and occludin (0.56±0.17 vs.1.30±0.27,P<0.01) in burn group quantitatively.The degrees in B+SP7 group were less than those in burn group (P<0.01).In B+SP14 group,only occludin decreased more.Conclusions This study suggested that severe thermal injury damaged the intestinal mucosal barrier.Splenectomy may provide a therapeutic benefit in restoring burn induced intestinal barrier by decreasing the release of inflammatory cytokines and recovering tight junction proteins.
Keywords:thermal injury  spleen  cytokine  tight junction protein  intestinal mucosal barrier  rat
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