急性颅脑损伤动物的胃肠动力研究

【作者】 张晖；

【导师】 马遂；

【作者基本信息】 北京协和医学院 ， 临床医学， 2009， 博士

【摘要】 目的：本实验的目的就是研究在急性颅脑损伤初期胃肠动力的改变以及相关影响因素的变化,为临床治疗急性创伤后的胃肠道并发症提供理论和实验室基础。材料和方法：Wistar大鼠50只,分为正常对照组,损伤后6小时组,24小时组,48小时组,72小时组,每组10只。利用Marmarou颅脑打击模型,造成急性颅脑损伤,测定急性期胃肠传输率,门脉血中VIP、胃泌素、胃动素含量,取小肠标本制作病理标本,光镜下观察ICC形态及数量的变化,电镜下观察其结构变化。结果：1.各损伤组与空白对照组相比,胃肠传输率均有显著下降(p<0.001)。胃肠传输率与急性颅脑损伤后神经行为学评分呈显著的中度正相关关系(p<0.05)。2.各损伤组门脉血中VIP含量与对照组相比,均有显著性上升(p<0.05),胃泌素各组含量有上升,24小时组有显著性差异(p<0.05),胃动素含量24小时组有显著性上升(p<0.05),不同实验组中,胃肠传输率与激素,及各种激素之间有不同的相关关系(p<0.05)。3.免疫组化染色及电镜观察到小肠中主要分布着ICC-MY和ICC-DMP两类ICC细胞,半定量统计结果,损伤组与对照组无明显差异。电镜未见结构异常。结论：急性重度颅脑损伤后,6小时起即发生胃肠动力障碍,并且出现胃肠激素的相应变化,直至72小时未完全恢复,ICC细胞72小时内未发生数目、形态、结构等的变化。更多还原

【Abstract】 Objective:to investigate the change of gastrointestinal motility in the state of acute severe head injury and the change of related factors.Methods:50Wistar rats were randomly divided into5groups with10each:Blank group,6hours after trauma group,24hours after trauma group,48hours after trauma group,72hours after trauma group. Make severe head injury model with Marmarou’s modeling. Then at the predicted time check the gastrointestinal transmission rate, concentration of VIP,GAS and MTL in the pylic blood, the morphous, number and structure of ICCs distributed in the small intestine muscle layers.Results:1.6h-72h after severe head injury, in trauma groups,a function disturbance of gastrointestinal motility could be observed(p<0.001).2. In all trauma groups VIP went up significantly (p<0.05), and GAS went up significantly (p<0.05) in24hour after trauma group, and MTL went up significantly (p<0.05) in the24hour after trauma group. In different groups there were positive or negative correlations significantly between the gastrointestinal transit ratio and hormones, as well as among different hormones.(p<0.05)3. with immunohistochemical method and in TEM ICC-MY和ICC-DMP were both observed, but no obvious differences were observed between blank group and trauma groups.Conclusion:6h after severe head injury, a function disturbance of gastrointestinal transit could be observed and wouldn’t recover until72h. And gastrointestinal hormones changed significantly. But no obvious differences were observed in ICC among different groups.更多还原