大鼠小肠移植物热缺血再灌注损伤研究

目的：探讨大鼠小肠移植物热缺血再灌注损伤后肠黏膜损伤、修复与再生的规律及其参与因素。方法：建立近交系大鼠异位小肠移植热缺血再灌注损伤模型，按热缺血时间0、15、30、60、120min分为5组。分别于移植术后取外周血，测定一氧化氮（NO）、内皮素-1（ET-1）的含量；同期对移植肠标本行常规组织学检查；并观察受体大鼠及移植物的生存率。结果：各组移植物及受鼠7d生存率为100％（6／6）。术后第7天，各热缺血组小肠黏膜组织学评分趋于一致，与非热缺血组之间的差异有统计学意义（P〈0．01）。术后第1天ET-1／NO与小肠黏膜组织学评分具有相关性。结论：大鼠小肠移植物在无心跳供体中可以耐受120min的热缺血；热缺血时间对移植术后小肠黏膜修复与再生无明显影响；移植术后早期外周血NO／ET-1失衡可能参与热缺血再灌注损伤。

Research on Warm Ischemia/Reperfusion Injury following Small Bowel Transplantation in Rat

Objective: To investigate the effects of warm ischemic reperfusion injury in the graft of rat small bowel transplantation. Methods: Heterotopic small bowel transplantation models were established with inbred rats F344. The rats were divided into 5 groups, including 0, 15, 30, 60, 120 min warm ischemia time respectively. The peripheral blood sample was taken to assay nitric oxide (NO) and endothelin-1 (ET-1) on series points of respectively postoperative day (POD) 1, 3 and 7. Simultaneously, small bowel biopsies were gotten for routine histopathological examination. The survival rates of recipient rats and grafts were observed.Results: (1)The one week survival rates of recipient rats and grafts in all groups were 100%. (2)On POD7, there were no apparent differences in mucosal injury among warm ischemia groups. (3)There was a correlation between the ratio of NO/ET-1 and the score of mucosal lesions on POD1. Conclusion: (1)The graft of rat small bowel transplantation was well tolerated 120 min of warm ischemia in non-heart-beating donor. (2)There is no significant effect on repair and regeneration of grafted small bowel mucosa by increasing warm ischemia time. (3)The disorder of NO/ET-1 may take part in warm ischemia/reperfusion injury.