摘要
目的 通过分析重症腹腔感染大鼠肠系膜淋巴液的成分,探讨重症腹腔感染时肠淋巴途径的作用.方法 将24只雄性Wistar大鼠按随机数字表法分为模型组与假手术组,每组12只.采用腹腔注射人工胃液联合大肠杆菌的方法制备重症腹腔感染模型.收集各组大鼠制模后4h的肠系膜淋巴液,进行白细胞计数及分类;检测肠淋巴液中内毒素、碱性磷酸酶（AKP）、乳酸脱氢酶（LDH）、肌酸激酶（CK）、谷氨酰胺转移酶（GST）、蛋白及各细胞因子的浓度.结果 重症腹腔感染大鼠肠淋巴液中中性粒细胞比例较假手术组明显升高（0.167±0.004比0.061±0.006,t=33.520,P＜0.001）,而巨噬细胞（0.009±0.001比0.020±0.004,t=-6.677,P＜0.001）及淋巴细胞比例（0.824±0.005比0.921±0.004,t=-31.471,P＜0.001）较假手术组明显降低.与假手术组比较,模型组大鼠肠淋巴液中内毒素水平（kEU/L：0.346±0.022比0.186±0.001,t=18.103,P＜0.001）、AKP[U（金氏）：13.97±5.55比3.76±0.18,t=4.503,P=0.006]、LDH（U/L：2 827.45±1 940.32比712.68±14.09,t=2.670,P=0.044）、CK（kU/L：2.19±1.21比0.70±0.01,t=3.035,P=0.029）、GST活性（kU/L：12.33±6.53比1.36±0.39,t=4.105,P=0.009）均明显升高,肠淋巴液中蛋白（g/L：4.40±0.48比2.84±0.16,t=6.882,P-0.001）、肿瘤坏死因子-α[TNF-α（ng/L）：499.39±76.36比180.90±70.98,t=7.483,P＜0.001]、白细胞介素-6[IL-6（μg/L）：13.74±0.78比-0.07±0.07,t=52.972,P=0.001]、细胞间黏附分子-1[ICAM-1（ng/L）：2 754.19±221.48比1 362.85±393.43,t=6.891,P＜0.001]、单核细胞趋化蛋白-1[MCP-1（μg/L）：28.23±1.77比24.87±1.15,t=3.561,P=0.007]及高迁移率族蛋白B1[HMGB1 （ng/L）：1 392.78±572.42比564.17±21.32,t=3.543,P=0.016]水平均明显升高.结论 肠淋巴途径可能是重症腹腔感染导致远隔器官损伤的早期途径.
Objective To investigate the components of mesenteric lymph of the rats with severe intraperitoneal infection,and inquire into the effect of intestinal lymphatic pathway in severe intraperitoneal infection.Methods Twenty-four male Wistar rats were randomly divided into two groups according to random number table method,namely model group and sham group with 12 rats in each group.The rat model of severe intraperitoneal infection was reproduced by injecting artificial gastric juice and E.coli intraperitoneally.Mesenteric lymph in both groups was collected 4 hours after the reproduction of the model,and white blood cells were counted and classified.The levels of endotoxin,alkaline phosphatase （AKP）,lactate dehydrogenase （LDH）,creatine kinase （CK）,glutamine transferase （GST）,protein and cytokines of mesenteric lymph were determined.Results Compared with the sham group,there was an increase in the neutrophil ratio in mesenteric lymph （0.167 ± 0.004 vs.0.610 ± 0.006,t=33.520,P＜0.001）,however the percentage of both macrophages （0.009 ± 0.001 vs.0.020 ± 0.004,t=-6.677,P＜0.001） and lymphocytes （0.824 ± 0.005 vs.0.921 ± 0.004,t=-31.471,P＜0.001） was decreased in model group.Compared with sham group,the levels ofendotoxin （kEU/L：0.346 ±0.022 vs.0.186 ±0.001,t=18.103,P＜0.001）,AKP [U （king unit）：13.97 ± 5.55 vs.3.76 ± 0.18,t=4.503,P=0.006],LDH （U/L：2 827.45 ± 1 940.32 vs.712.68 ± 14.09,t=2.670,P=0.044）,CK （kU/L：2.19 ± 1.21 vs.0.70 ± 0.01,t=3.035,P=0.029）,GST （kU/L：12.33 ± 6.53 vs.1.36 ± 0.39,t=4.105,P=0.009） were all significantly elevated.The concentration of protein （g/L：4.40 ± 0.48 vs.2.84 ± 0.16,t=6.882,P=0.001）,tumor necrosis factor-α [TNF-α （ng/L）：499.39 ±76.36 vs.180.90 ± 70.98,t=7.483,P＜0.001],interleukin-6 [IL-6 （μg/L）：13.74 ± 0.78 vs.-0.07 ± 0.07,t=52.972,P＜0.001],intercellular adhesion molecule-1 [ICAM-1 （ng/L）：2 754.19 ±221.48 vs.1 362.85 ±393.43,t=6.891,P＜0.001] and monocyte chemo-attractant protein-1 [MCP-1 （μg/L）：28.23 ± 1.77 vs.24.87 ± 1.15,t=3.561,P=0.007] and high mobility group protein-1 [HMGB-1 （ng/L）：1 392.78 ± 572.42 vs.564.17 ± 21.32,t=3.543,P=0.016] in mesenteric lymph in model group were significantly higher than those in sham group.Conclusion Intestinal lymphatic pathway maybe the early pathway for the production of remote organ injury caused by severe intraperitoneal infection.
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2014年第7期503-507,共5页
Chinese Critical Care Medicine
基金
目家重点基础研究发展计划（973）项目（2009CB522703）
关键词
重症腹腔感染
肠淋巴液
内毒素
酶类
细胞因子
Severe intraperitoneal infection
Mesenteric lymph
Endotoxin
Enzyme
Cytokine
