2型糖尿病大鼠肠系膜微循环改变及其临床意义

目的 研究2型糖尿病大鼠肠系膜微血管和微血流的变化。方法 Otsuka-long-evans-tokushima fatty（OLETF）2型糖尿病大鼠33只，对照组long-evanstokushima otsuka（LETO）非糖尿病大鼠7只，全麻状态下，使用带电脑图像处理装置的微循环活体观察电视显微镜对糖尿病和非糖尿病对照组大鼠作活体肠系膜微循环观察。检测微血管分支数目、微动脉及微静脉口径、微静脉中沿壁滚动与贴壁黏附的白细胞数、微动脉边流和轴流的宽度、内皮细胞厚度等。实验结果经电视录像记录后用图像处理系统定量测定。结果 糖尿病大鼠肠系膜微血管分支数与对照组大鼠比较减少24．5％（P〈0．01），微血管分支数与血糖水平呈负相关（r=-0．44，P〈0．05）；糖尿病大鼠微动脉边流宽度小于对照组，边流与管径的比值显著减少（P〈0．01），沿壁滚动与贴壁黏附白细胞明显增加（P〈0．01），免疫细胞化学结果显示糖尿病大鼠肠系膜微血管内皮细胞表面血管细胞黏附分子1（Vascular cell adhesion molecule-1，VCAM-1）表达明显增强。结论 糖尿病大鼠肠系膜微循环出现明显的微血管与微血流形态、结构和功能障碍，这些变化是糖尿病微血管病和各种并发征发生的基础。

Changes of mesentery microcirculation in type 2 diabetic rats and its clinical significance

Purpose To study the dysfunction of microvessels and micro-blood-flow in mesentery microcirculation of type 2 diabetic rats. Methods Thirty-three otsuka-long-evans-tokushima fatty (OLETF) type 2 diabetic rats and 7 long-evans tokushima otsuka (LETO) non-diabetic control rats were used in the study. After general anesthesia, a video microscope with image analysis system was used to observe the mesentery microcirculation in diabetic rats and the control rats. Microvascular number, diameter of arterioles and venules, number of rolling and sticking leukocytes on the surface of venules endothelium, width of marginal flow and axial flow in the arterioles and thickness of endothelium were measured. The results were measured quantitatively with the video microscopic image analysis system. Using ABC method, the vascular cell adhesion molecule-1(VCAM-1) immunocytochemical staining was performed. Results Comparing with control rats, the microvascular number in the mesentery of diabetic rats reduced by 24.5(P<0.01), and it was inversely correlated to blood sugar level(r=-0.44,P<0.05).The width of marginal flow in diabetic rats decreased, the ratio of width of marginal flow to width of arteriole reduced significantly(P<0.01), rolling and sticking leukocyte number adhered to the endothelium in the venule increased significantly(P<0.01). Results of immunocytochemistry showed that the expression of VCAM-1 on the surface of microvascular endothelial cells in the mesentery increased markedly. Conclusions The overt microvascular abnormality and micro-blood-flow dysfunction is shown in mesentery microcirculation of diabetic rats. They are the pathogenetic basis of microangiopathy and various complications in diabetic rats.