藻酸双酯钠预防术后肠粘连的实验研究_医学论文.docVIP

藻酸双酯钠预防术后肠粘连的实验研究_医学论文 藻酸双酯钠预防术后肠粘连的实验研究_医学论文 【摘要】 　　目的 观察藻酸双酯钠预防术后肠粘连的作用。方法 选用雌性Wistar大鼠36只，刮伤其盲肠浆膜，创面滴无水乙醇，钳夹盲肠系膜动脉制造大鼠肠粘连的动物模型, 随机将动物分成3组，分别在关腹前于创面涂布藻酸双酯钠、透明质酸钠、生理盐水，术后14 d将大鼠处死, 肉眼观察肠粘连程度并对粘连组织的基质金属蛋白酶(MMP)和金属蛋白酶组织抑制物(TIMP)水平进行检测。结果 与生理盐水组比较，藻酸双酯钠组和透明质酸钠组均能降低术后肠粘连的程度（H=21.98，0.05）；藻酸双酯钠组和透明质酸钠组MMP的表达显著高于生理盐水组(F=29.34,q=5.27、10.83,0.01)藻酸双酯钠组和透明质酸钠组TIMP的表达显著低于生理盐水组(F=83.22,q=10.51、18.17, 0.01)。结论 藻酸双酯钠具有预防术后肠粘连的作用。 【关键词】 藻酸双酯钠 肠粘连 基质金属蛋白酶类 金属蛋白酶组织抑制物 　　［ABSTRACT］ Objective To assess the effect of polysaccharide sulphate (PSS) on prevention of postoperative intestinal adhesions. Methods This study consisted of 36 male Wistar rats. A rat model of intestinal adhesions was done as follows: serous membrane of the caecum was scuffed, its raw surface was dropped with absolute alcohol, the mesentric artery of the caecum was then clamped. The rats were divided into three groups. PSS, sodium hyaluronate or normal saline was applied to the scraped cecum before closing the abdomen. The rats were killed 14 days after the operation, the adhesions were graded macroscopically, the content of matrix metalloproteinase 2 (MMP2) and tissue inhibitors of matrix metalloproteinase 2 (TIMP2) in adhesive tissues were determined. Results Compared with normal saline, both PSS and sodium hyaluronate evidently reduced the extent of postoperative intestinal adhesions (H=21.98,0.05), and the expression of TIMP2 was decreased (F=83.22q=10.51,18.170.01) while MMP2 was increased (F=29.34q=5.27,10.830.01). Conclusion Postoperative intestinal adhesions can be prevented by polysaccharide sulphate. 　　［KEY WORDS］ Polysaccharide sulphate Intestinal adhesions Matrix metalloproteinases Tissue inhibitors of matrix metalloproteinase 　　外科盆腹腔术后肠粘连一直是临床工作中的一大难题，如顽固性腹痛、不育及粘连性肠梗阻等，后者如不及时处理将导致腹腔炎、水电解质紊乱甚至危及生命。藻酸双酯钠(PSS)主要用于治疗缺血性心脑血管疾病等，外科可用于治疗手术后粘连、血栓性脉管炎等[1]。基质金属蛋白酶(MMP)2是一类能够降解细胞外基质(ECM)的蛋白质，金属蛋白酶组织抑制物(TIMP)2是MMP2的抑制剂，能够下调MMP2的活性。MMP2主要在组织重建、修复、细胞迁移、血管生成、炎症反应、伤口愈合、肿瘤侵袭和转移等过程中发挥重要作用。近年还发现，MMP2