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目的探讨丙氨酰—谷氨酰胺双肽对缺血/再灌注损伤兔肠道黏膜屏障的保护作用。方法选择健康成年新西兰兔30只,按随机数字表法分为观察组与对照组各15只。采用完全夹闭阻断肠系膜上动脉后再开放恢复血流方法成功建立缺血/再灌注肠损伤模型后,模型建立前、后2h,观察组通过耳缘静脉分别给予丙氨酰—谷氨酰胺双肽一次(剂量为1.0g/kg)。对照组同期分别给予等量的葡萄糖生理盐水静脉注射。4h后,空气栓塞法处死新西兰兔。苏木素—伊红染色光镜下观察损伤肠组织的病理学变化,依据Chiu 6级评分法计算肠损伤程度评分。测量小肠组织中丙二醇(MDA)、髓过氧化物酶(MPO)、超氧化物歧化酶(SOD)的浓度变化。摘取肠系膜淋巴结制作匀浆后行细菌培养,选取部分菌落与肠内容物细菌做菌种鉴定比较,检测肠道细菌移位情况。结果观察组MDA、MPO水平和Chiu 6级评分低于对照组,SOD水平高于对照组,差异均有统计学意义(P<0.01)。观察组菌落计数水平为(467.94±154.29)×105CFU/ml少于对照组的(876.44±185.41)×105CFU/ml,菌种确定具有一致性(两者一致性检验Kappa=0.79),绝大部分为肠道常驻菌,以革兰阴性杆菌为主。结论丙氨酰—谷氨酰胺双肽能够保护缺血再灌注损伤后肠黏膜屏障功能,减少肠道菌群移位,其机制可能与抑制缺血/再灌注后肠道黏膜脂质过氧化,减少中心粒细胞浸润及增加抗氧化功能有关。
Objective To investigate the protective effect of alanyl-glutamine dipeptide on intestinal mucosal barrier in rabbits with ischemia / reperfusion injury. Methods Thirty healthy adult New Zealand rabbits were randomly divided into observation group and control group according to random number table. After complete occlusion of the superior mesenteric artery and then open to restore blood flow, a model of intestinal injury after ischemia / reperfusion was successfully established. Two hours before and after model establishment, the rabbits in the observation group were given alanyl-glutamine Double peptide once (at a dose of 1.0 g / kg). The control group were given the same amount of glucose saline intravenously during the same period. After 4h, New Zealand rabbits were sacrificed by air embolism. The pathological changes of intestinal tissue were observed under hematoxylin-eosin staining, and the score of intestinal injury was calculated according to Chiu 6-grade score. The changes of concentration of propanediol (MDA), myeloperoxidase (MPO) and superoxide dismutase (SOD) in small intestine were measured. Mesenteric lymph nodes were harvested and homogenized for bacterial culture. Part of colonies and enteric bacteria were selected for bacterial identification, and the intestinal bacterial translocation was detected. Results The levels of MDA, MPO and Chiu 6 in the observation group were lower than those in the control group, and the levels of SOD were higher in the observation group than in the control group (P <0.01). The colony count of the observation group was (467.94 ± 154.29) × 105CFU / ml less than that of the control group (876.44 ± 185.41) × 105CFU / ml, and the strain identification was consistent (Kappa = 0.79 for both consistency test) For the intestinal bacteria, Gram-negative bacilli-based. Conclusions Alanyl-glutamine dipeptide can protect the intestinal mucosal barrier function and reduce the intestinal flora shift after ischemia-reperfusion injury. The mechanism may be related to inhibition of intestinal mucosal lipid peroxidation after ischemia / reperfusion, Reduce central granulocyte infiltration and increase anti-oxidant function.