Toll样受体4介导心肺复苏后肠粘膜损伤的研究

目的探讨Toll样受体4（TLR4）信号在心脏骤停及复苏后肠粘膜损伤中的作用。方法采用15只雄性大鼠建立心脏骤停及心肺复苏模型（窒息法），自主循环恢复后，留取回肠标本，观察6、24和48小时肠粘膜的形态学改变及损伤情况：Westernblot检测回肠粘膜TLR4表达，以及ELISA法测定粘膜肿瘤坏死因子-α（TNF-α）的释放。结果复苏后动物肠粘膜显著受损，损伤程度均明显高于假手术组（sham）（P〈0．01），其中6小时组为甚；TLR4表达在3个时间段均明显强于sham（P〈0．001），并伴随着TNF-α表达升高。TLR4表达强弱与TNF-α释放及粘膜损伤程度变化呈正相关（P〈0．05）。结论本研究与其他疾病研究结果基本相符合，心肺复苏后肠粘膜损伤伴随着TLR4的高炎症信号，TLR4信号失控通过诱导炎性介质产生导致复苏后肠粘膜损伤。

Study on Toll-like receptor mediated intestinal mucosal injury after cardiopulmonary resuscitation in a rat model

Objective To investigate the role of toll-like receptor 4 （TLR4）signal in the intestinal mucosal injury after cardiac arrest and cardiopulmonary resuscitation. Methods The cardiac arrest and cardiopulmonary resuscitation model were established in male Sprague-Dawley rats. After automatic circulatory recovery, the ileal specimens were taken. The morphologicaf change and injuried condition of intestinal mucosa were observed in 6,24 and 48 hours respectively. The ileal mucosal TLR4 expression was detected by western blot method and liberation of mucosal tumor necrosis factor- （TNF-α）was determined by Elisa method. Results The intestinal mucosa was damaged significantly after resuscitation. Its damaged degree was obviously higher than that false control group （P 〈0.01 ） especially in 6 hours group. TLR4 expressions were obviously stronger than that control group in the three time sigments （P 〈 0.01 ）and accompanied TNF-α expressions were elevated. TLR4 expression strong-weak with TNF-α liberation and change of mucosal damage degree showed a positive correlation （P 〈 0.05）. Conclusion This research is agree with study results of other diseases. Intestinal mucosal injury would accompany a high inflammatory signal of TLR4 after cardio pulmonary resuscitation. The uncontrolled TLR4 signal results in intestinal mucosal injury after resuscitation through induced inflammatory mediator.