褪黑素对肠缺血再灌注损伤保护作用的临床研究

目的 研究褪黑素对肠缺血再灌注损伤(IIRI)的保护作用.方法 研究对象随机分为缺血再灌注A组,生理盐水处理B组,地塞米松治疗C组,褪黑素治疗D组,每组20例.手术解除肠缺血前后10min分别静脉注射生理盐水10ml、地塞米松20mg和褪黑素20μg,手术结束后1h内采外周静脉血,用MDA、SOD试剂盒测定血浆MDA浓度和SOD活性.用NO试剂盒和酶学分光光度法测定血浆NO2-/NO3-水平和血浆D-乳酸水平.观察处理后各组肠管颜色完全恢复时间和术后肛门排气时间.结果 褪黑素治疗组与生理盐水处理组和地塞米松治疗组比较,血浆SOD活性明显上升(P＜0.01),MDA浓度降低(P＜0.05),血浆中NO2-/NO3-浓度上升(P＜0.05),D-乳酸明显降低(P＜0.01),各组肠管颜色完全恢复时间和术后肛门排气时间均有缩短(P＜0.05).结论 褪黑素对肠缺血再灌注损伤有较好保护作用,其机制可能是通过清除氧自由基,防止脂质过氧化和保护肠黏膜机械屏障.

Clinical study on the protective effects of Melatonin on intestinal ischemia reperfusion injury

Objective To assess the protective effect of Melatonin on intestinal ischemia reperfusion injury for intestinal ischemia patients by operational treatment.Methods Intestinal ischemia patients were randomly divided into four groups,they were ischemia reperfusion(IR)(A),IR+NS(B),IR+DSM(C)and IR+MT(D).The later three groups were injected in NS(10ml),DSM(20mg) and MT(20μg) through vein at 10 minute prior to reperfusion and 10 minute after the reperfusion period.After operations were finished in an hour,superoxide dismutase(SOD) activities and malondiadehyde(MDA) contents in vein blood plasma were detected respectively;plasma NO2-/NO3-and D-lactate contents were measured.Time of intestinal colour renewed on operation and the anus exhaust after operation was determined.Results SOD activities were significantly higher(P<0.01),MDA contents were lower in plasma(P<0.05);Plasma NO2-/NO3-contents were higher(P<0.05),D-lactate contents were significantly lower(P<0.01);Time of intestinal colour renew on operation and the anus exhaust after operation was shorten(P<0.05).Conclusion MT-treated group has some protective effects on intestinal ischemia reperfusion injury for intestinal ischemia patients by operational treatment.The mechanism may relate to cleaning free oxygen radicals for inhibitting lipid peroxidation and protecting intestinal mucosal complete barrier function.