新型经直肠亚低温治疗对缺血缺氧性脑损伤SD大鼠肠道细菌移位影响的实验研究

发布时间：2018-04-15 22:29

本文选题：经直肠亚低温 + 缺血缺氧性脑损伤　；参考：《重庆医科大学》2015年硕士论文

【摘要】：目的观察新型经直肠亚低温治疗对缺血缺氧性脑损伤SD大鼠肠道细菌移位的影响,以评估其安全性,为新型经直肠亚低温治疗的临床应用提供实验依据。方法本实验选用30只健康成年SD雄性大鼠,随机分成三组：假手术组(C,n=6)、常温缺血缺氧组(OT,n=12)、经直肠亚低温缺血缺氧组(MH, n=12)。 OT组和MH组均建立缺血缺氧性脑损伤模型,MH组经肛门插入密闭式储水囊,通过双腔密闭式储水囊持续灌注等渗冰盐水,进行经直肠亚低温治疗,12h后回笼自然复温。三组均于缺血缺氧后Oh、12h、24h取血检测二胺氧化酶(DAO)、D-乳酸浓度,24h开腹取肝、脾、肠系膜淋巴结进行细菌培养,取直肠组织行HE染色。结果1.肠粘膜形态学变化：C组直肠结构完整。OT组肠上皮脱落坏死,部分粘膜结构消失,上皮细胞排列紊乱,粘膜下层大量炎性细胞浸润。MH组直肠组织结构完整,粘膜下层少量炎性浸润表现。2.细菌培养：实验结果显示,三组均发现细菌移位,组间无统计学差异(P0.05)。C组和MH组只在肠系膜淋巴结培养出细菌,且细菌培养鉴定结果全部为大肠杆菌。OT组细菌移位部位主要为肠系膜淋巴结,其次为肝脏、脾脏,与MH组比较无统计学差异(P0.05)。OT组细菌移位部位与细菌移位路径一致,提示未经过亚低温干预的HIBD大鼠细菌移位路径更远。OT培养出的细菌主要为大肠杆菌、嗜麦芽窄食单胞菌、洛菲不动杆菌。MH组与C组细菌移位率相比,没有统计学差异(P0.05)。3.血液DAO、D-乳酸浓度变化：MH组12h血DAO、D-乳酸浓度变化均较Oh显著降低(P0.05)。结论1.新型经直肠亚低温治疗能维持直肠组织学的完整性,对直肠无损伤。采用双腔密闭式储水囊,冰水不直接接触直肠粘膜,可避免水中毒并发症的发生。2.新型经直肠亚低温治疗不会加重HIBD大鼠的细菌移位,能维护肠道微生态平衡。3.新型经直肠亚低温治疗对HIBD大鼠肠道屏障有良好的保护作用,对肠粘膜通透性有降低作用。4.前期及本次动物实验结果表明,新型经直肠亚低温治疗安全可靠,具有便携、价廉、简便、无创、安全的优点。下一步将进行临床试验以验证其临床应用的安全性。
[Abstract]:Objective to observe the effect of new transrectal mild hypothermia therapy on intestinal bacterial translocation in SD rats with ischemic and hypoxic brain injury in order to evaluate its safety and provide experimental evidence for clinical application of new transrectal mild hypothermia therapy.Methods Thirty healthy adult SD male rats were randomly divided into three groups: sham operation group (n = 6), normothermic ischemia and hypoxia group (n = 12), transrectal hypothermia ischemia / hypoxia group (n = 12) and transrectal hypothermia ischemia / hypoxia group (n = 12).The model of ischemic hypoxic brain injury was established in the OT group and MH group. In the MH group, the closed water storage sac was inserted into the anus, and the cryogenic saline was continuously infused through the double-chamber closed water storage capsule. After 12 hours of transrectal mild hypothermia treatment, natural rewarming was achieved.The blood samples of all the three groups were collected at 12h after ischemia and hypoxia to detect the concentration of diamine oxidase (DAOX) D-lactic acid. The liver, spleen and mesenteric lymph nodes were collected for bacterial culture at 24 h after operation. The rectal tissues were stained with HE.Result 1.Intestinal mucosal morphology changes. The rectum structure of group C was intact. In group OT, the intestinal epithelium was exfoliated and necrotic, some of the mucosal structure disappeared, the epithelial cells were arranged in disorder, and a large number of inflammatory cells were infiltrated in the submucous layer.Submucous submucosa small amount of inflammatory infiltration. 2.Bacterial culture: the results showed that bacterial translocation was found in all three groups. There was no statistical difference between the three groups. Group C and MH only cultured bacteria in mesenteric lymph nodes.The bacterial translocation in E. coli. OT group was mainly mesenteric lymph node, followed by liver and spleen. There was no significant difference between MH group and MH group.The results indicated that the bacterial translocation pathway of HIBD rats without mild hypothermia intervention was more distant. OT culture bacteria were mainly Escherichia coli, Stenotrophomonas maltophilia, and there was no significant difference in bacterial translocation rate between Acinetobacter alopicum group and C group (P 0.05. 3).Changes of DAOD- lactate concentration in blood in the w / MH group for 12 h, the changes of DAOD- lactic acid concentration were significantly lower than that of Oh in the control group (P 0.05).Conclusion 1.New transrectal mild hypothermia therapy can maintain the integrity of rectum histology and no injury to rectum.Double-chamber closed water storage sac, ice water does not directly contact the rectal mucosa, can avoid water poisoning complications. 2. 2.The new transrectal mild hypothermia therapy does not aggravate bacterial translocation in HIBD rats and can maintain intestinal microecological balance. 3.The new transrectal mild hypothermia therapy has a good protective effect on intestinal barrier in HIBD rats and a decrease of intestinal mucosal permeability.The results of previous and animal experiments show that the new transrectal hypothermia therapy is safe, reliable, portable, inexpensive, simple, non-invasive and safe.Next, clinical trials will be conducted to verify the safety of its clinical applications.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R45

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