目的:颅脑火器伤对肠黏膜通透性的影响。方法:选用40只成年健康雄性杂种犬,运用随机数字抽样法分成8组并造模:常温常湿正常血糖组(A组)、高温高湿高血糖组(B组)、常温常湿正常血糖颅脑火器伤组(C组)、常温常湿高血糖颅脑火器伤组(D组)、高温高湿正常血糖颅脑火器伤组(E组)、高温高湿高血糖颅脑火器伤组(F组)、常温常湿高血糖组(G组)、高温高湿正常血糖组(H组)。标本采集:每组5只分别在剖腹后0h时、0.5h时、1.0h时、1.5h时、2.0h时五个时间点,切取距回盲部1~3cm的末端回肠组织,快速将残端吻合并关腹,末端回肠组织制作成标本。采集每只实验犬开腹后0h时、0.5h时、1.0h时、1.5h时、2.0h时五个时间点的外周血标本。观察指标:采用ELISA方法定量检测每只实验犬上述五个时间点外周血中D-乳酸、二胺氧化酶(DAO)的浓度。将末端回肠组织标本,用光学显微镜观察,进行肠黏膜损害指数评分,并进行肠黏膜损害指数与D-乳酸、DAO的浓度的相关性分析。用电子显微镜观察线粒体的受损程度,对线粒体进行评分,并进行线粒体的损伤指数与D-乳酸、DAO的浓度的相关性分析。结果:各组实验犬肠黏膜损害指数均随时间延长而递增,差异有统计学意义(P<0.05);且肠黏膜损害指数与外周血中D-乳酸及DAO的浓度均呈现正相关。各组实验犬肠黏膜线粒体受损指数均随时间延长而递增,差异有统计学意义(P<0.05);且线粒体受损指数与外周血中D-乳酸及DAO的浓度均呈现正相关。结论:颅脑火器伤可导致肠黏膜损害,且随时间延长而加重,引起肠黏膜通透性不断增加。 Objective: The effect of craniocerebral gunshot wound on intestinal mucosal permeability. Methods: Forty male adult male dogs were randomly divided into 8 groups and were randomly divided into four groups: normal temperature and humidity group (A group), high temperature, high humidity and hyperglycemia group (B group), normal temperature and humidity, normal blood glucose (C group), normal temperature and humidity hyperglycemia craniocerebral firearm injury group (D group), high temperature and humidity normal blood glucose craniocerebral injury group (E group), high temperature, high humidity and hyperglycemia craniocerebral firearm injury group (Group F), normal temperature and humidity hyperglycemia group (group G), high temperature and humidity normal blood glucose group (group H). Specimen collection: Each group of five were taken at 0h, 0.5h, 1.0h, 1.5h, 2.0h after cesarean section at five time points, the terminal ileum tissue 1 ~ 3cm away from the ileocecal part, the rapid will be residual Anastomosis and abdominal closure, the terminal ileum tissue made into specimens. Peripheral blood samples were collected from each experimental dog at 0h, 0.5h, 1.0h, 1.5h and 2.0h after laparotomy. OUTCOME MEASURES: The concentration of D-lactate and diamine oxidase (DAO) in the peripheral blood of each experimental dog at the above five time points was quantitatively determined by ELISA. The terminal ileum tissue specimens were observed with light microscope, the index of intestinal mucosal damage index was scored and the relationship between intestinal mucosal damage index and D-lactate and DAO concentration was analyzed. The degree of mitochondrial damage was observed with an electron microscope, and mitochondria were scored. The correlation analysis between mitochondrial damage index and concentration of D-lactate and DAO was carried out. Results: The index of intestinal mucosal damage in experimental groups increased with time, the difference was statistically significant (P <0.05). The index of intestinal mucosal damage was positively correlated with the concentrations of D-lactate and DAO in peripheral blood. The mitochondrial damage index of intestinal mucosa in experimental groups increased with time, the difference was statistically significant (P <0.05); and mitochondrial damage index and peripheral blood D-lactic acid and DAO concentrations were positively correlated. CONCLUSION: Firearm injury of craniocerebral can cause intestinal mucosal damage and aggravate with time, resulting in increasing permeability of intestinal mucosa.