小肠缺血再灌注损伤在肠套叠患儿的临床观察

目的 观察肠套叠患儿血清一氧化氮（NO）浓度和肠黏膜细胞凋亡的相关性，分析其对临床症状及预后的影响。方法急性单纯性阑尾炎组为对照，检测术前血清NO和超氧化物歧化酶（SOD）浓度；组织切片黏膜细胞TUNEI。染色阳性细胞数和caspase-3平均灰度值。结果 肠套叠组血清NO浓度明显升高（P〈0．05）；血清SOD浓度与对照组无差异。阑尾组织匀浆MDA含量高于对照组；肠套叠组阑尾黏膜内TUNEI。染色阳性细胞数、caspase-3平均灰度值均高于对照组（P〈0．05）。肠套叠组血清NO浓度与术前血白细胞计数呈正相关（r=0．82，P〈0．001）。白细胞及血清NO浓度均升高的患儿，术后恢复相对较慢，高热持续时间延长，腹泻、腹胀等并发症增加。结论 肠套叠相关的缺血再灌注损伤伴随血清NO浓度升高，与术前血白细胞计数呈正相关；肠黏膜损伤及细胞凋亡程度影响患儿术后恢复。

Clinical observation of intestinal ischemia reperfusion injury in intussusception

Objective To investigate the relationship between patients' clinical symptoms with intussusception and intestinal ischemia-reperfusion injury by observing serum nitric oxide(NO) and mucosal apoptosis.Methods Patients with intussusception was designated as Group A and patients with acute simple appendicitis as Group B.Serum concentration of NO,superoxide dismutase(SOD),and malondialdehyde(MDA) content of appendix tissue homogenate were measured.TUNEL positive cell numbers and cleaved caspase-3 staining intensity were measured.Results The concentration of serum NO in Group A is higher than that of Group B,(P<(0.05)).NO concentration has positive correlation with white blood cell(WBC),r~(2)=(0.82),P<(0.001).The MDA content of appendix tissue homogenate in Group A is significantly higher,P<(0.05).Mucosal apoptosis from group A is increased compared to Group B with higher TUNEL positive cells count and caspase-3 average gray level,P<(0.05).The higher levels,the more protracted the patients' recovery.Conclusions Patients with intussusception has elevated level of serum NO which positively correlates with WBC count.NO,apoptosis and IIR injury influence the prognosis of patients.