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目的探讨低分子肝素钙联合曲美他嗪对大鼠急性肠系膜静脉血栓(AMVT)肠道平滑肌的保护作用及其可能的作用机理。方法 120只雄性SD大鼠随机分为3组,每组40只。低分子肝素钙组(LHC组):建立AMVT模型术后大鼠给予LHC(30 U/100 g)皮下注射,每隔12 h重复给药,直至术后72 h;低分子肝素钙+曲美他嗪组(LHCT组):建立AMVT模型术后大鼠给予LHC(30 U/100 g)皮下注射,同时经尾静脉注射曲美他嗪(10 mg/kg),每隔12 h重复给药,直至术后72 h;生理盐水组(NS组):建立AMVT模型术后大鼠给予NS0.2 m L/100 g皮下注射,每隔12 h重复给药,直至术后72 h。结扎回肠肠系膜上静脉及边缘静脉弓建立AMVT周围模型,分别于术后6、12、24、48及72 h采集下腔静脉血3 m L及3份重量均为200 mg的回肠组织,采用ELISA试剂盒检测每组不同时间段血清中丙二醛(MDA)、肌酸激酶(CK)及肠道组织匀浆液中三磷酸腺苷(ATP)水平,光镜下观察各时间点肠道组织HE染色做出病理学损伤评分。结果与LHC组及NS组相比,LHCT组血清中MDA及CK含量及肠道组织病理学损伤评分均明显降低,期差异有统计学意义(P<0.05),肠道组织中ATP水平明显升高,差异也有统计学意义(P<0.05)。结论曲美他嗪可能通过改善大鼠AMVT时肠道平滑肌的能量代谢,在联合LHC治疗AMVT周围型疾病中,可减轻肠道平滑肌损伤,避免肠道发生透壁性坏死,可保护肠道平滑肌。
Objective To investigate the protective effect of low molecular weight heparin combined with trimetazidine on intestinal smooth muscle of acute mesenteric vein thrombosis (AMVT) in rats and its possible mechanism. Methods 120 male SD rats were randomly divided into three groups of 40 rats. Low molecular weight heparin group (LHC group): After AMVT model was established, rats were injected subcutaneously with LHC (30 U / 100 g) and repeated every 12 h until 72 h after operation. Low molecular weight heparin + (LHCT group): After AMVT model was established, rats were injected subcutaneously with LHC (30 U / 100 g) and trimetazidine (10 mg / kg) via caudal vein and repeated every 12 h (NS group). After the AMVT model was established, the rats were injected subcutaneously with NS 0.2 m L / 100 g and repeated every 12 h until 72 h after the operation. The model of AMVT was established by ligating the ileal superior mesenteric vein and the marginal venous arch. At 3, 6, 12, 24, 48 and 72 h postoperatively, 3 mL of IVC and 200 mg of ileal tissue were collected. The serum levels of malondialdehyde (MDA), creatine kinase (CK) and intestinal homogenate of ATP in each group were detected by kit at different time points. The intestinal tissue HE staining was performed under light microscope Pathological damage score. Results Compared with LHC group and NS group, the serum levels of MDA and CK and the histopathological damage scores of LHCT group were significantly decreased (P <0.05), and the levels of ATP in intestinal tissue were significantly increased The differences were also statistically significant (P <0.05). Conclusion Trimetazidine may reduce intestinal smooth muscle injury, prevent transmural necrosis of intestine and protect the intestinal smooth muscle in the AMVT-associated peripheral disease by improving the AMVT in rats. .