犬腦梗塞應(yīng)激時蔗糖通透性檢測評價胃屏障功能的研究
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犬腦梗塞應(yīng)激時蔗糖通透性檢測評價胃屏障功能的研究
劉業(yè)成 齊志偉 馬遂
中國協(xié)和醫(yī)科大學北京協(xié)和醫(yī)院急診科 100730
摘要：目的：評估腦梗塞應(yīng)激時胃屏障功能變化，并檢測用蔗糖通透性評價胃屏障的有效性。方法：20只犬參與實驗。10只犬制做腦梗塞模型后，胃管入含蔗糖50g的NS300ml，檢測5小時和24小時的蔗糖通透性，24h后取胃病理做大體分級和組織學積分，比較這些結(jié)果和偽手術(shù)組10只犬相應(yīng)結(jié)果有無區(qū)別。同時把蔗糖通透性和大體病理及組織學積分結(jié)果做相關(guān)性分析，以判斷蔗糖通透性檢測的有效性。結(jié)果：實驗組和偽手術(shù)組比較，5小時和24小時尿蔗糖通透性都有顯著差異( p<0.05)，病理的大體分級和組織學積分都有顯著性差異(p<0.05)；蔗糖通透性和胃大體病理結(jié)果程正相關(guān)，(r=0.89,p<0.05)，和胃組織學病理積分結(jié)果也程正相關(guān)(r=0.83,p<0.05)。結(jié)論：腦梗塞應(yīng)激時胃屏障功能有顯著破壞，蔗糖通透性檢測可以作為評價胃屏障功能的可靠而易行的辦法。
關(guān)鍵詞： 應(yīng)激，腦梗塞，胃屏障功能
The investigation of evaluating the function of gastric barrier by sucrose permeability in the stress of cerebral infarction in dogs
Department of emergency medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, china
Abstract: Objective: To evaluate the change of gastric barrier function in the stress of cerebral infarction, and assess the value of sucrose permeability in the evaluation of gastric barrier.Method:20 dogs were studied.10 dogs were made cerebral infarction by operation and fed with 50g sucrose within 300ml NS by gastric tube, and the later 5h and 24h urine sucrose excretion were measured. The dogs were sacrificed for gastric gross classification and histological score 24h after infarction. All the result were compared with the 10 dogs in sham group. Combined with the result of the gastric gross classification and histological score ,the result of the sucrose permeability were analyzed. Result :The sucrose permeability, gastric gross classification and histological score in the infarction group were all significantly different(p<0.05) from the sham group. And the result of the sucrose permeability were correlated with that of the gastric gross classification (r=0.89,p<0.05)and histological score(r=0.83,p<0.05).Conclusion: The gastric barrier were severe damaged in cerebral infarction, and the measurement of sucrose permeability is a simple and reliable means of assessing gastric barrier function.
Key words: stress, cerebral infarction, the function of gastric barrier
胃腸道目前被認為是急性疾病的應(yīng)激的中心器官，表現(xiàn)早、且對長期預(yù)后可能起關(guān)鍵作用。胃腸道的各項功能中，最受人關(guān)注的是屏障功能。急性疾病的應(yīng)激導(dǎo)致胃腸屏障破壞的機制，目前多數(shù)學者認為核心的病理生理改變是胃腸低灌注。但是臨床觀察到許多急性疾病的應(yīng)激并無低灌注的證據(jù)，有關(guān)在這個過程中是否會出現(xiàn)胃腸屏障損傷的研究甚少。
本研究選擇急性腦梗塞做急性應(yīng)激的模型，嚴格控制實驗條件，杜絕低血壓、缺氧，盡量消除其它因素對胃造成的損害。用尿蔗糖測定的方法監(jiān)測腦梗塞后各時間段上消化道屏障功能的變化，用檢測結(jié)束后的病理大體分級、組織學積分結(jié)果做是否有胃屏障損傷的證實。同時把病理結(jié)果和蔗糖結(jié)果做比較，進一步印證蔗糖實驗的可靠性，也為今后此實驗用于臨床監(jiān)測應(yīng)激后的胃屏障改變提供依據(jù)。
1.材料與方法
1.1材料
雜種犬20只，體重 (15±2)kg，雌性。由北京協(xié)和醫(yī)院動物實驗中心提供。采用隨即數(shù)字表法，把實驗動物隨機平均分為實驗組和偽手術(shù)組。
1.2動物模型制作
雜犬實驗前晚禁食水，稱重量后，以3%戊巴比妥鈉20mg/kg肌肉注射，麻醉后持續(xù)監(jiān)測體表心電、舌下血氧，并定時監(jiān)測體溫，經(jīng)口置入直徑7.5mm 的氣管導(dǎo)管，下胃管，左股動脈seldinger法置入深靜脈管建立靜脈通路，右股動脈seldinger法置入動脈留置針，接壓力套裝持續(xù)監(jiān)測動脈血壓，膀胱造瘺接尿管記尿量。分離右側(cè)頸動脈，實驗組切開動脈后置入事先準備好的1.1×8mm硅膠柱2枚，制成腦梗塞模型，7-0血管縫線縫合切口；偽手術(shù)組無置入栓子步驟，余同實驗組。整個過程保證血壓心率穩(wěn)定、尿量充足。制模成功后24h梗塞組犬行頭顱CT檢查證實腦梗塞。
1.3尿樣本采取
實驗組腦栓塞后0h、19h分別胃管入含蔗糖(Amresco公司提供，純度>99.9%)50g的NS 300ml,留5小時尿，計量，置于含10%麝香草酚的異丙醇5ml的容器內(nèi)以防止細菌對糖的分解。(1)記總量后留尿樣10ml備檢測蔗糖濃度。對照組偽手術(shù)后同樣留取各點5小時尿測蔗糖濃度。
1.4蔗糖測定
蔗糖檢測試劑盒：Megazyme公司生物及食品酶法分析試劑盒 ......
犬腦梗塞應(yīng)激時蔗糖通透性檢測評價胃屏障功能的研究
劉業(yè)成 齊志偉 馬遂
中國協(xié)和醫(yī)科大學北京協(xié)和醫(yī)院急診科 100730
摘要：目的：評估腦梗塞應(yīng)激時胃屏障功能變化，并檢測用蔗糖通透性評價胃屏障的有效性。方法：20只犬參與實驗。10只犬制做腦梗塞模型后，胃管入含蔗糖50g的NS300ml，檢測5小時和24小時的蔗糖通透性，24h后取胃病理做大體分級和組織學積分，比較這些結(jié)果和偽手術(shù)組10只犬相應(yīng)結(jié)果有無區(qū)別。同時把蔗糖通透性和大體病理及組織學積分結(jié)果做相關(guān)性分析，以判斷蔗糖通透性檢測的有效性。結(jié)果：實驗組和偽手術(shù)組比較，5小時和24小時尿蔗糖通透性都有顯著差異( p<0.05)，病理的大體分級和組織學積分都有顯著性差異(p<0.05)；蔗糖通透性和胃大體病理結(jié)果程正相關(guān)，(r=0.89,p<0.05)，和胃組織學病理積分結(jié)果也程正相關(guān)(r=0.83,p<0.05)。結(jié)論：腦梗塞應(yīng)激時胃屏障功能有顯著破壞，蔗糖通透性檢測可以作為評價胃屏障功能的可靠而易行的辦法。
關(guān)鍵詞： 應(yīng)激，腦梗塞，胃屏障功能
The investigation of evaluating the function of gastric barrier by sucrose permeability in the stress of cerebral infarction in dogs
Department of emergency medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, china
Abstract: Objective: To evaluate the change of gastric barrier function in the stress of cerebral infarction, and assess the value of sucrose permeability in the evaluation of gastric barrier.Method:20 dogs were studied.10 dogs were made cerebral infarction by operation and fed with 50g sucrose within 300ml NS by gastric tube, and the later 5h and 24h urine sucrose excretion were measured. The dogs were sacrificed for gastric gross classification and histological score 24h after infarction. All the result were compared with the 10 dogs in sham group. Combined with the result of the gastric gross classification and histological score ,the result of the sucrose permeability were analyzed. Result :The sucrose permeability, gastric gross classification and histological score in the infarction group were all significantly different(p<0.05) from the sham group. And the result of the sucrose permeability were correlated with that of the gastric gross classification (r=0.89,p<0.05)and histological score(r=0.83,p<0.05).Conclusion: The gastric barrier were severe damaged in cerebral infarction, and the measurement of sucrose permeability is a simple and reliable means of assessing gastric barrier function.
Key words: stress, cerebral infarction, the function of gastric barrier
胃腸道目前被認為是急性疾病的應(yīng)激的中心器官，表現(xiàn)早、且對長期預(yù)后可能起關(guān)鍵作用。胃腸道的各項功能中，最受人關(guān)注的是屏障功能。急性疾病的應(yīng)激導(dǎo)致胃腸屏障破壞的機制，目前多數(shù)學者認為核心的病理生理改變是胃腸低灌注。但是臨床觀察到許多急性疾病的應(yīng)激并無低灌注的證據(jù)，有關(guān)在這個過程中是否會出現(xiàn)胃腸屏障損傷的研究甚少。
本研究選擇急性腦梗塞做急性應(yīng)激的模型，嚴格控制實驗條件，杜絕低血壓、缺氧，盡量消除其它因素對胃造成的損害。用尿蔗糖測定的方法監(jiān)測腦梗塞后各時間段上消化道屏障功能的變化，用檢測結(jié)束后的病理大體分級、組織學積分結(jié)果做是否有胃屏障損傷的證實。同時把病理結(jié)果和蔗糖結(jié)果做比較，進一步印證蔗糖實驗的可靠性，也為今后此實驗用于臨床監(jiān)測應(yīng)激后的胃屏障改變提供依據(jù)。
1.材料與方法
1.1材料
雜種犬20只，體重 (15±2)kg，雌性。由北京協(xié)和醫(yī)院動物實驗中心提供。采用隨即數(shù)字表法，把實驗動物隨機平均分為實驗組和偽手術(shù)組。
1.2動物模型制作
雜犬實驗前晚禁食水，稱重量后，以3%戊巴比妥鈉20mg/kg肌肉注射，麻醉后持續(xù)監(jiān)測體表心電、舌下血氧，并定時監(jiān)測體溫，經(jīng)口置入直徑7.5mm 的氣管導(dǎo)管，下胃管，左股動脈seldinger法置入深靜脈管建立靜脈通路，右股動脈seldinger法置入動脈留置針，接壓力套裝持續(xù)監(jiān)測動脈血壓，膀胱造瘺接尿管記尿量。分離右側(cè)頸動脈，實驗組切開動脈后置入事先準備好的1.1×8mm硅膠柱2枚，制成腦梗塞模型，7-0血管縫線縫合切口；偽手術(shù)組無置入栓子步驟，余同實驗組。整個過程保證血壓心率穩(wěn)定、尿量充足。制模成功后24h梗塞組犬行頭顱CT檢查證實腦梗塞。
1.3尿樣本采取
實驗組腦栓塞后0h、19h分別胃管入含蔗糖(Amresco公司提供，純度>99.9%)50g的NS 300ml,留5小時尿，計量，置于含10%麝香草酚的異丙醇5ml的容器內(nèi)以防止細菌對糖的分解。(1)記總量后留尿樣10ml備檢測蔗糖濃度。對照組偽手術(shù)后同樣留取各點5小時尿測蔗糖濃度。
1.4蔗糖測定
蔗糖檢測試劑盒：Megazyme公司生物及食品酶法分析試劑盒 ......
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