严重腹腔感染时血、粪纳米细菌的检测及其与SIRS关系的实验研究

目的探讨严重腹腔感染时血、粪中纳米细菌（nanobacteria，NB）的检测情况及其与全身炎症反应综合征（SIRS）的关系。方法40只SD大鼠采用盲肠结扎加穿孔手术（CLP）制作严重腹腔感染模型，分别于术前、术后2d取血、粪标本进行NB培养，电镜下观察NB并加以鉴定。另取回肠组织作病理观察。结果造模后的大鼠符合SIRS标准，病理观察肠黏膜层部分区域有黏膜上皮脱落，肠上皮细胞间紧密连接出现异常，结构松弛。与CLP手术前比较，术后2d体温（℃）显著升高（39．98±0．43vs38．37±0．34=18．538，P〈0．01），血液白细胞计数（×10^9／L）亦明显增高（21．13±3．27vss10．43±2．23，f=15．909，P〈0．01）。严重腹腔感染前、后血电镜下NB阳性率分别为17．5％和42．5％（X2=5．952，P=0．015），粪NB阳性率分别为90．0％和92．5％，差异无统计学意义（X0=0．156，P=0．692）。结论严重腹腔感染sD大鼠血中纳米细菌较感染前显著增加，可能与SIRS的发生发展有关。

Experimental studies on the relationship between nanobacteria translocation and SIRS of rats which suffering critical infection of abdominal cavity

Objective To explore the relationship between nanobacteria（NB） translocation from blood and stool and SIRS of rats suffering critical infection of abdominal cavity. Methods Forty SD rats were involved in the study. The models of critical abdominal cavity infection were made by cecal ligation plus puncture （CLP）. The test samples of blood and stool were obtained before and two days after infected, respectively. The samples were cultured with NB culture medium and identified by transmission electron microscopy （TEM）. The morphological change of the pathologic lesion in the ileum tissue of the rats were observed. Results Two days after infected, it showed epithelia abscission and tight junction loosening in some area of intestinal mucosa of the rats. Compared with preoperative, the average rectal temperature of the experimental group rats was higher significantly （39.98 ± 0.43 vs 38.37 ± 0.34, t = 18.538, P 〈 0.01）, and the average numer of leukocyte （x 109/L） was higher significantly（21.13 ± 3.27 vs 10.43 ± 2.23, t = 15.909, P 〈 0.01） at postoperative 2 d. The positive rates of NB were 17.5% and 42.5% （X2 = 5.952, P = 0.015） in the blood samples before and after CLP 2 d respectively by TEM, and that were 90.0% and 92.5% （X2 = 0.156, P = 0.692） in the stool. Conehmion The positive rates of NB increases in the bloodsamples, which may be associated with SIRS induced by critical abdominal cavity infection.