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创伤失血性休克大鼠血清D 乳酸、二胺氧化酶和内毒素的变化及其对肠黏膜损伤的意义
刘海,彭晓静,郭平选,王太,张建新,席文娟
0
(开滦总医院麻醉科)
摘要:
【摘要】 目的 探讨创伤失血性休克对大鼠血清D乳酸、二胺氧化酶和内毒素的水平及其对肠黏膜屏障功能的影响。方法 选取成年雄性SD大鼠50只,按照随机数表法将大鼠分为对照组、休克1h组、休克4h组、休克8h组、休克16h组,每组各10只。建立大鼠创伤失血性休克模型后,采用比色法来测定大鼠血清中的二胺氧化酶(DAO)活性;采用光度法来测定大鼠血清中的内毒素、D乳酸水平。切取大鼠回肠末端组织,观察组织结构病理变化。检测对照组与休克1h组相同时间点采集静脉血液和回肠末端组织。结果 各组大鼠静脉血中D乳酸、二胺氧化酶和内毒素含量组间比较差异有统计学意义(P<005)。对照组大鼠肠上皮组织结构完整,无水肿,绒毛无脱落且形态正常。休克1h组肠黏膜组织结构完整,肠绒毛形态不规则;休克4h组部分肠上皮脱落,局部存在水肿,无明显炎细胞浸润;休克8h组上皮组织脱落增多,局部水肿明显,固有层内可见明显炎细胞浸润;休克16h组上皮组织大面积脱落,水肿严重,固有层内炎细胞浸润较8h组更加明显。结论 创伤失血性休克早期即发生肠屏障功能障碍,血清D乳酸、DAO和内毒素是肠黏膜损伤早期诊断的敏感指标,且其水平与肠黏膜组织的病理改变程度呈正相关。
关键词:  失血性休克  D 乳酸  二胺氧化酶  内毒素  肠黏膜损伤
DOI:
基金项目:河北省医学科学研究重点课题(ZD20140064)
Changes of serum D lactic acid, diamine oxidase and endotoxin of trauma hemorrhagic shock rats and its significance
LIU Hai,PENG Xiaojing,GUO Pingxuan,WANG Tai,ZHANG Jianxin,XI Wenjuan
(Department of Anesthesiology, Kailuan General Hospital)
Abstract:
【Abstract】 Objective To investigate the effects of traumatic hemorrhagic shock on serum Dlactic acid, diamine oxidase and endotoxin and their effects on intestinal mucosal barrier function in rats. Methods Fifty adult male SpragueDawley rats were selected and randomly divided into control group (n=10), 1h shock group (n=10), 4h shock group (n=10), 8h shock group (n=10) and16h shock group (n=10). After the traumatic hemorrhagic shock model was established in rats, colorimetric assay was used to measure the DAO activity in rat serum. The endotoxin and Dlactic acid levels in rat serum were determined by spectrophotometry. Rat ileum tissue was harvested and the histopathological changes were observed. Venous blood and ileal tissue were collected at the same time points in the control group and the shock 1h group for detection and observation. Results Dlactic acid, Diamine oxidase and endotoxin levels in each group were statistically different. In the control group, the intestinal epithelium was structurally intact and no villus was absent and the morphology was normal. In the observation group, the intestinal mucosal structure was intact and the intestinal villi were irregular in the 1h shock group; Part of the intestinal epithelium was shed in the 4h shock group, with local edema and no obvious inflammatory cell infiltration; The epithelial shedding of the 8h group was increased, and the local edema was obvious. There was obvious inflammatory cell infiltration in the lamina propria; The epithelial tissue in the 16h group was severely shedding, and the edema was severe. The infiltration of inflammatory cells in the lamina propria was more obvious than that in the 8h group. Conclusion In the early stage of traumatic hemorrhagic shock, intestinal barrier dysfunction occurs. Serum Dlactic acid, DAO and endotoxin are sensitive indicators for the early diagnosis of intestinal mucosal injury, and their levels are positively correlated with the pathological changes of intestinal mucosal tissues.
Key words:  Hemorrhagic shock  D lactic acid  DAO  Endotoxin  Infestinal mucosal injury

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