犬脑梗塞应激时蔗糖通透性检测评价胃屏障功能的研究
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犬脑梗塞应激时蔗糖通透性检测评价胃屏障功能的研究
刘业成 齐志伟 马遂
中国协和医科大学北京协和医院急诊科 100730
摘要：目的：评估脑梗塞应激时胃屏障功能变化，并检测用蔗糖通透性评价胃屏障的有效性。方法：20只犬参与实验。10只犬制做脑梗塞模型后，胃管入含蔗糖50g的NS300ml，检测5小时和24小时的蔗糖通透性，24h后取胃病理做大体分级和组织学积分，比较这些结果和伪手术组10只犬相应结果有无区别。同时把蔗糖通透性和大体病理及组织学积分结果做相关性分析，以判断蔗糖通透性检测的有效性。结果：实验组和伪手术组比较，5小时和24小时尿蔗糖通透性都有显著差异( p<0.05)，病理的大体分级和组织学积分都有显著性差异(p<0.05)；蔗糖通透性和胃大体病理结果程正相关，(r=0.89,p<0.05)，和胃组织学病理积分结果也程正相关(r=0.83,p<0.05)。结论：脑梗塞应激时胃屏障功能有显著破坏，蔗糖通透性检测可以作为评价胃屏障功能的可靠而易行的办法。
关键词： 应激，脑梗塞，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
胃肠道目前被认为是急性疾病的应激的中心器官，表现早、且对长期预后可能起关键作用。胃肠道的各项功能中，最受人关注的是屏障功能。急性疾病的应激导致胃肠屏障破坏的机制，目前多数学者认为核心的病理生理改变是胃肠低灌注。但是临床观察到许多急性疾病的应激并无低灌注的证据，有关在这个过程中是否会出现胃肠屏障损伤的研究甚少。
本研究选择急性脑梗塞做急性应激的模型，严格控制实验条件，杜绝低血压、缺氧，尽量消除其它因素对胃造成的损害。用尿蔗糖测定的方法监测脑梗塞后各时间段上消化道屏障功能的变化，用检测结束后的病理大体分级、组织学积分结果做是否有胃屏障损伤的证实。同时把病理结果和蔗糖结果做比较，进一步印证蔗糖实验的可靠性，也为今后此实验用于临床监测应激后的胃屏障改变提供依据。
1.材料与方法
1.1材料
杂种犬20只，体重 (15±2)kg，雌性。由北京协和医院动物实验中心提供。采用随即数字表法，把实验动物随机平均分为实验组和伪手术组。
1.2动物模型制作
杂犬实验前晚禁食水，称重量后，以3%戊巴比妥钠20mg/kg肌肉注射，麻醉后持续监测体表心电、舌下血氧，并定时监测体温，经口置入直径7.5mm 的气管导管，下胃管，左股动脉seldinger法置入深静脉管建立静脉通路，右股动脉seldinger法置入动脉留置针，接压力套装持续监测动脉血压，膀胱造瘘接尿管记尿量。分离右侧颈动脉，实验组切开动脉后置入事先准备好的1.1×8mm硅胶柱2枚，制成脑梗塞模型，7-0血管缝线缝合切口；伪手术组无置入栓子步骤，余同实验组。整个过程保证血压心率稳定、尿量充足。制模成功后24h梗塞组犬行头颅CT检查证实脑梗塞。
1.3尿样本采取
实验组脑栓塞后0h、19h分别胃管入含蔗糖(Amresco公司提供，纯度>99.9%)50g的NS 300ml,留5小时尿，计量，置于含10%麝香草酚的异丙醇5ml的容器内以防止细菌对糖的分解。(1)记总量后留尿样10ml备检测蔗糖浓度。对照组伪手术后同样留取各点5小时尿测蔗糖浓度。
1.4蔗糖测定
蔗糖检测试剂盒：Megazyme公司生物及食品酶法分析试剂盒 ......
犬脑梗塞应激时蔗糖通透性检测评价胃屏障功能的研究
刘业成 齐志伟 马遂
中国协和医科大学北京协和医院急诊科 100730
摘要：目的：评估脑梗塞应激时胃屏障功能变化，并检测用蔗糖通透性评价胃屏障的有效性。方法：20只犬参与实验。10只犬制做脑梗塞模型后，胃管入含蔗糖50g的NS300ml，检测5小时和24小时的蔗糖通透性，24h后取胃病理做大体分级和组织学积分，比较这些结果和伪手术组10只犬相应结果有无区别。同时把蔗糖通透性和大体病理及组织学积分结果做相关性分析，以判断蔗糖通透性检测的有效性。结果：实验组和伪手术组比较，5小时和24小时尿蔗糖通透性都有显著差异( p<0.05)，病理的大体分级和组织学积分都有显著性差异(p<0.05)；蔗糖通透性和胃大体病理结果程正相关，(r=0.89,p<0.05)，和胃组织学病理积分结果也程正相关(r=0.83,p<0.05)。结论：脑梗塞应激时胃屏障功能有显著破坏，蔗糖通透性检测可以作为评价胃屏障功能的可靠而易行的办法。
关键词： 应激，脑梗塞，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
胃肠道目前被认为是急性疾病的应激的中心器官，表现早、且对长期预后可能起关键作用。胃肠道的各项功能中，最受人关注的是屏障功能。急性疾病的应激导致胃肠屏障破坏的机制，目前多数学者认为核心的病理生理改变是胃肠低灌注。但是临床观察到许多急性疾病的应激并无低灌注的证据，有关在这个过程中是否会出现胃肠屏障损伤的研究甚少。
本研究选择急性脑梗塞做急性应激的模型，严格控制实验条件，杜绝低血压、缺氧，尽量消除其它因素对胃造成的损害。用尿蔗糖测定的方法监测脑梗塞后各时间段上消化道屏障功能的变化，用检测结束后的病理大体分级、组织学积分结果做是否有胃屏障损伤的证实。同时把病理结果和蔗糖结果做比较，进一步印证蔗糖实验的可靠性，也为今后此实验用于临床监测应激后的胃屏障改变提供依据。
1.材料与方法
1.1材料
杂种犬20只，体重 (15±2)kg，雌性。由北京协和医院动物实验中心提供。采用随即数字表法，把实验动物随机平均分为实验组和伪手术组。
1.2动物模型制作
杂犬实验前晚禁食水，称重量后，以3%戊巴比妥钠20mg/kg肌肉注射，麻醉后持续监测体表心电、舌下血氧，并定时监测体温，经口置入直径7.5mm 的气管导管，下胃管，左股动脉seldinger法置入深静脉管建立静脉通路，右股动脉seldinger法置入动脉留置针，接压力套装持续监测动脉血压，膀胱造瘘接尿管记尿量。分离右侧颈动脉，实验组切开动脉后置入事先准备好的1.1×8mm硅胶柱2枚，制成脑梗塞模型，7-0血管缝线缝合切口；伪手术组无置入栓子步骤，余同实验组。整个过程保证血压心率稳定、尿量充足。制模成功后24h梗塞组犬行头颅CT检查证实脑梗塞。
1.3尿样本采取
实验组脑栓塞后0h、19h分别胃管入含蔗糖(Amresco公司提供，纯度>99.9%)50g的NS 300ml,留5小时尿，计量，置于含10%麝香草酚的异丙醇5ml的容器内以防止细菌对糖的分解。(1)记总量后留尿样10ml备检测蔗糖浓度。对照组伪手术后同样留取各点5小时尿测蔗糖浓度。
1.4蔗糖测定
蔗糖检测试剂盒：Megazyme公司生物及食品酶法分析试剂盒 ......
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