氢水联合缺血后处理对大鼠小肠缺血再灌注损伤的保护作用

目的观察氢水联合缺血后处理对大鼠小肠缺血再灌注引起的小肠及远隔脏器损伤的保护作用。方法将60只大鼠随机分为假手术组(SO组)、缺血再灌注组(IR组)、氢水组(HS组)、缺血后处理组(IP组)和氢水联合缺血后处理组(IP-HS组),每组12只。建立小肠缺血再灌注大鼠模型。再灌注2 h后采集各组大鼠静脉血及小肠、肝、肺组织,测定血清中肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6、IL-10和内毒素水平,测定血清及小肠、肝和肺组织中丙二醛(MDA)水平及髓过氧化物酶(MPO)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)活性。Chiu 6级评分法观察肠黏膜损伤情况,细菌培养观察细菌移位率。结果 IR组、HS组、IP组和IP-HS组大鼠肠黏膜绒毛损伤评分显著高于SO组(P<0.05),HS组、IP组和IP-HS组大鼠肠黏膜绒毛损伤评分显著低于IR组(P<0.05);HS组、IP组和IP-HS组大鼠肠黏膜绒毛损伤评分比较差异均无统计学意义(P>0.05)。SO组大鼠腹膜、肝、肺组织均无细菌移位,IR组、HS组、IP组、IP-HS组大鼠肝脏与腹膜细菌移位率比较差异均无统计学意义(P>0.05)。IR组、HS组、IP组、IP-HS组大鼠血清中TNF-α、IL-1β、IL-6、IL-10和内毒素水平显著高于SO组(P<0.05,P<0.01);HS组、IP组、IP-HS组大鼠血清中TNF-α、IL-1β、IL-6和内毒素水平显著低于IR组(P<0.05,P<0.01),IP-HS组大鼠血清中TNF-α、IL-1β、IL-6、内毒素水平显著低于HS组和IP组(P<0.05,P<0.01);HS组、IP组、IP-HS组大鼠血清中IL-10水平明显高于IR组(P<0.05,P<0.01);IP-HS组大鼠血清中IL-10水平显著高于HS组和IP组(P<0.05)。IR组、HS组、IP组、IP-HS组大鼠血清及小肠、肝、肺组织中MPO活性和MDA水平显著高于SO组(P<0.05,P<0.01),HS组、IP组、IP-HS组大鼠血清及小肠、肝、肺组织中MPO活性和MDA水平显著低于IR组(P<0.05,P<0.01),IP-HS组大鼠血清及小肠、肝、肺组织中MPO活性和MDA水平显著低于HS组和IP组(P<0.05)。IR组、HS组、IP组、IP-HS组大鼠血清及小肠、肝、肺组织中SOD、CAT活性显著低于SO组(P<0.01),HS组、IP组、IP-HS组大鼠血清及小肠、肝、肺组织中SOD、CAT活性显著高于IR组(P<0.05,P<0.01),IP-HS组大鼠血清及小肠、肝、肺组织中SOD、CAT活性显著高于HS组和IP组(P<0.05)。结论氢水联合缺血后处理可以减轻大鼠小肠缺血再灌注损伤,其效果优于二者单独应用。

Protective effect of hydrogen saline combined with ischemic post-conditioning on intestinal ischemia reperfusion in rats

Objective To observe the protective effect of hydrogen saline combined with ischemic post-conditioning on intestina parva and remote organs injuries induced by intestinal ischemia reperfusion. Methods Sixty rats were randomly di- vided into sham operation group（ SO group）, ischemia-reperfusion group（ IR group）, hydrogen saline group（ HS group）, ische- mic post-conditioning group（ IP group） and IP-HS group;twelve rats in each group. The models of intestinal ischemia reperfu- sion were established in rats. Two hours after reperfusion, the venous blood, intestina parva, liver and lung tissues of rats in each group were collected. The levels of tumor necrosis factor-α （TNF-α）, interleukin （IL）-1β, IL-6, IL-10 and endotoxin in serum were detected. The levels of malondialdehyde （MDA） and the activity of myeloperoxidase （ MPO ）, catalase （ CAT）, su- peroxide dismutase （SOD） in serum, intestina parva,liver and lung tissues were detected. The intestinal mncosae injury was evaluated by Chiu-6 standard scoring. Results The intestinal mucosal villi injury score of rats in IR, HS, IP and IP-HS groups were significantly higher than that in SO group（ P 〈 0.05 ）. The intestinal mucosal villi injury score of rats in HS, IP and IP-HS groups was significantly higher than that in IR group（ P 〈 0.05 ）. There was no significant difference in intestinal mucosal villi injury score among HS, IP and IP-HS groups （P 〉 0.05 ）. There was no bacterial metachoresis in peritoneum, liver and lung tis- sue of rats in SO group. There was no significant difference in liver and peritoneal bacterial metachoresis rate among IR, HS, IP and IP-HS groups （P 〉 0.05）. The levels of serum TNF-α, IL-1β, IL-6, IL-10 and endotoxin of rats in IR, HS, IP and IP-HS groups were significantly higher than those in SO group （ P 〈 0.05, P 〈 0.01 ）. The levels of serum TNF-α, IL-1β, IL-6, IL-10 and endotoxin of rats in HS,IP and IP-HS groups were significantly lower than those in IR group（P 〈0.05 ,P 〈0.01 ）. The levels of serum TNF-α, IL-1β, IL-6, IL-10 and endotoxin of rats in IP-HS group were significantly lower than those in HS and IP group（P 〈0.05 ,P 〈0.01 ）. The level of serum IL-10 of rats in HS,IP and IP-HS groups was significantly higher than that in IR group（P 〈0.05 ,P 〈 0.01 ）. The level of serum IL-10 in IP-HS group was significantly lower than that in HS and IP group （ P 〈 0.05 ）. The MPO activity and MDA level of serum and peritoneum,liver,lung tissue in IR, HS, IP and IP-HS groups were significantly higher than those in SO group（P 〈 0.05 ,P 〈 0.01 ）. The MPO activity and MDA level of serum and perito- neum, liver, lung tissue in HS, IP and IP-HS groups were significantly lower than those in IR group （ P 〈 0.05, P 〈 0.01 ）. The MPO activity and MDA level of serum and peritoneum,liver,lung tissue in IP-HS groups were significantly lower than those in HS group and IP group（P 〈 0.05）. The SOD and CAT activity of serum and peritoneum, liver, lung tissue in IR, HS, IP and IP-HS groups were significantly lower than those in SO group（ P 〈 0.01 ）. The SOD and CAT activity of serum and peritoneum, liver, lung tissue in HS, IP and IP-HS groups were significantly higher than those in IR group（ P 〈 0.05, P 〈 0.01 ）. The SOD and CAT activity of serum and peritoneum,liver,lung tissue in IP-HS groups were significantly higher than those in HS and IP groups（P 〈 0.05 ）. Conclusion Hydrogen saline combined with ischemic post-conditioning can reduce intestinal ischemia reperfusion injury in rats, and the effect is better than single application of them.