大黄对胃肠手术后大鼠肠道黏膜屏障损伤的影响-普通外科学专业论文 word格式.docxVIP

大黄对胃肠手术后大鼠肠道黏膜屏障损伤的影响摘要目的：观察大黄对胃肠手术手术后大鼠肠道黏膜屏障的影响，探讨大黄对胃 肠手术后大鼠肠黏膜屏障功能的影响机制，为胃肠手术后肠黏膜屏障功能损伤 的治疗探寻新的方向。方法：30只雄性SD大鼠(体重180-200g)随机分为对照组10只、损伤组10只、 大黄组10只。对照组用专用饲料饲养，余无特殊处理。损伤组及大黄组大鼠行 盲肠切除+胃造瘘置管手术，手术当天及术后第1天给予阿莫西林50mg+甲硝唑 20mg各一次。两组大鼠于术后给予肠内营养 (各只大鼠等氮等热卡），大黄组在 以上肠内营养基础上给予大黄浓缩颗粒溶液灌胃（0.25g/d/只)干预。7天后， 三组大鼠用双抗体夹心ABC-ELISA法测定血浆TNF-α水平；取大鼠末端回肠组 织，光镜下观察肠黏膜的病理变化，并采用免疫组化SP法染色测定肠黏膜中紧 密连接蛋白 ZO-1蛋白表达。结果：1、与对照组比较，损伤组血浆 TNF-α水平明显增高，差异有统计学意义 (P0.05)；与损伤组比较，大黄组 TNF-α水平明显降低，差异有统计学意义 (P0.05)；大黄组与对照组差异无统计学意义。2、损伤组小肠黏膜上皮损伤较重，黏膜存在不同程度的水肿、萎缩，肠绒 毛有少许脱落；大黄组与损伤组相比，小肠黏膜损伤轻，无明显水肿萎缩改变， 仅可见部分肠绒毛变短、脱落。3、与对照组比较，损伤组肠黏膜ZO-1蛋白表达显著降低(P0.05)；与损伤 组比较，大黄组肠黏膜ZO-1蛋白表达显注升高(P0.05)，大黄组与对照组无明 显差异（P0.05)。结论：1．盲肠切除+胃造口手术成功建立了肠道黏膜屏障损伤的大鼠模型2. 大黄对胃肠手术后出现的肠黏膜屏障损伤有修复作用。 关键词：肠黏膜屏障；大黄；紧密连接蛋白；炎症介质；ZO-1；TNF-αThe Effects of Rhubarb on Intestinal Mucosal Barrier in Experimental Rats after Gastrointestinal Surgery AbstractObjective： To explore the effects and mechanism of rhubarb on intestinal mucosalbarrier in experimental rats after gastrointestinal surgery. Search for new treatments of intestinal mucosa injury after gastrointestinal surgery.Methods: Assign thirty male SD rats (weight 180-200g) into three groups：normalcontrol group （ 10 ） , injury group(10) and rhubarb treated group(10). There is no special treatment for the control group rats. Injury group and rhubarb treated groupreceived amoxicillin 50 mg+20g metronidazole twice after the cecectomy and gastrostomy. The rats which received operation would be given enteral nutrition for next 7 days . Rhubarb (0.25g/d) was given to rhubarb treated group everyday until executed. For each group, the concentrations of TNF-α in serum was detected by enzyme-linked immune sorbent assay.Taking tissue from terminal ileum,the morphology of the intestinal mucosa were observed by microscopy and the zonula occludens-1 in the ileum mucosa were measured with immunohistochemistry.Result：Compared with normal control group , the level of TNF － α in injury group was significantly higher(P