大鼠休克复苏后肠黏膜屏障特点的探讨

目的 探讨失血性休克肠缺血．再灌注损伤后黏膜屏障的形态学、功能与重建的特点。方法 制作大鼠失血性休克模型，于复苏后0、1、3、6、12、24h时间段活杀并进行光镜和电镜下肠黏膜组织形态学观察、内毒素含量及尿液乳果糖，甘露醇比值的测定。结果 肠黏膜主要表现为凋亡和坏死两种损伤形式，大部分肠黏膜于6h重建，12h结构基本恢复正常，肠杯状细胞数在各组呈下降趋势；内毒素和乳果糖，甘露醇比值在6h达高峰。结论 失血性休克后肠黏膜屏障早期受累，但同时具有快速重建能力；屏障功能的恢复滞后于形态学重建。

The characteristics of intestinal mucosal barrier in rats resuscitated after hemorrhagic shock

Objective To investigate the characteristics of functional and reconstitution of intestinal mucosal barrier after traumatic-hemorrhagic shock.Methods Specimens on ileum were taken at 0h,1h,3h,6h,12h and 24h after resuscitation.The morphological changes of intestinal mucosa were observed through light and electron microscope.At the same time points,hepato-portal vein blood was collected for endotoxin,and lactulose/mannitol ratio of urine was measured to analyze the change of intestinal mucosal barrier function respectively.Results The apoptosis and necrosis were main manifestations of intestinal mucosal injury after hemorrhagic shock. Most intestinal mucosa was entirely restored at 6h and finished at 12h. The number of goblet cells of intestinal mucosal was reduced. Urine lactulose/mannitol ratio and endotoxin content peaked at 6 h.Conclusion Intestinal mucosal barrier was seriously damaged at the early phase of ischemia-reperfusion injury after hemorrhagic shock, but intestinal mucosa has great repair potential. The restoration of intestinal barrier function is obviously slower than that of morphology.