选择性肠道去污染对创伤性截瘫家兔内毒素及炎症因子的影响
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四川省卫生厅科研课题(120579)


Effect of selective decontamination of the digestive tract on plasma endotoxinand and inflammatory crtokine in rabbits with complete paraplegia
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    【摘要】 目的 探讨选择性肠道去污染(SDD)对截瘫家兔血中内毒素(ET)、白介素6(IL6)、肿瘤坏死因子α (TNFα)和降钙素原(PCT)的影响,明确外周血炎症因子水平与肠黏膜屏障功能障碍的关系。方法建立截瘫家兔模型,采用PTA方案进行SDD处理4天。采集小肠标本进行HE染色观察小肠黏膜变化,并检测外周血ET和IL6、TNFα及PCT水平。结果 SDD处理后血浆ET浓度明显降低(P<0001),血中感染指标IL6、TNFα、PCT水平也较对照组明显降低(P<005)。相关分析表明,外周血内毒素水平与血浆IL6、TNFα、PCT呈显著正相关(P<005),小肠Chiu病理评分与IL6、TNFα、PCT、ET水平呈显著正相关 (P<001)。结论 SDD处理截瘫家兔后可减轻全身炎症反应,保护肠黏膜,减少肠道内毒素移位,从而预防肠源性感染。

    Abstract:

    【Abstract】 Objective To investigate changes of plasma endotoxin, interleukine6 (IL6), tumor necrosis factoralpha (TNFα) and procalcitonin (PCT) levels in paraplegic rabbits treated with selective digestive decontamination (SDD).Methods Animals were subjected to a complete paraplegia following spinal cord injury, and divided into SDDtreated and control groups. The treatment group received SDD using PTA protocol by gavage three times daily for 4 days after injury. The control group was given the same amount of normal saline. Plasma were collected to detect ET, IL6, TNFα and PCT concentrations, and samples from the small intestine were collected to assess morphological changes, using Hematoxylin and eosin staining. The correlation between ET, IL6, TNFα and PCT levels and the degree of intestinal mucosal damage were analyzed. Results Plasma ET concentration in SDD group was significantly lower than that in control group [(015(005) EU/ml vs (057(011) EU/ml, t=15341, P<0001). In addition, plasma IL6, TNFα, and PCT levels in SDD group were also obviously lower that in control group. Correlation analysis showed ET, IL6, TNFα and PCT levels were positively correlated with the degree of intestinal mucosal injury (P<005). Conclusion SDD alleviates systematic inflammatory reaction and decreases endotoxin translocation from the intestinal tract in rabbits with complete paraplegia.

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  • 在线发布日期: 2017-08-03
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