南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (08): 1171-.

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N-乙酰半胱氨酸对体外循环大鼠肠损伤的影响

许志扬,江国英,林世清,关军,陈国度,陈广泽   

  • 出版日期:2014-08-20 发布日期:2014-08-20

Effect of N-acetylcysteine on intestinal injury induced by cardiopulmonary bypass in rats

  • Online:2014-08-20 Published:2014-08-20

摘要: 目的观察N-乙酰半胱氨酸(NAC)对体外循环(CPB)大鼠肠损伤的影响。方法成年雄性SD大鼠32只,随机均分为假手
术组(S组)、NAC对照组(N组)、CPB组(C组)、CPB+NAC治疗组(NC组),每组8只。S组和N组仅置管和肝素化,不进行CPB,
C组和NC组进行CPB 1 h,然后观察2 h。N组和NC组在术前3天每天腹腔注射0.5 g/kg NAC,且NC 组在预充液中加入NAC
100 mg/kg,然后以20 mg/(kg·h)速度输注直到停转流,C组仅给予等量的生理盐水。CPB后2 h取小肠标本和血标本,观察肠组
织病理学改变,检测肠组织丙二醛(MDA)水平和超氧化物歧化酶(SOD)、谷胱甘肽(GSH)和谷胱甘肽过氧化物酶(GSH-Px)活
性和肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6及血清二胺氧化酶(DAO)水平。结果CPB后2 h,肠组织出现明显的损伤性改
变和氧化应激损伤;而NAC处理可以显著减轻小肠粘膜损伤,降低MDA和DAO,上调SOD、GSH和GSH-Px等抗氧化酶的活
性和降低TNF-α、IL-6水平。结论围术期使用NAC能够减轻CPB诱发的氧化应激和炎症反应的程度,对CPB诱发的肠损伤具
有一定的保护作用。

Abstract: Objective To observe the effect of N-acetylcysteine (NAC) on intestine injury induced by cardiopulmonary bypass
(CPB) in rats. Methods Thirty-two rats were randomly divided into sham-operated group, NAC control group, CPB model
group, and CPB plus NAC treatment group (n=8). In the latter two groups, the rats were subjected to CPB for 1 h. The rats
received intraperitoneal injections of normal saline or NAC (0.5 g/kg) as appropriate for 3 successive days prior to CPB, and
those in CPB plus NAC group were given NAC (100 mg/kg) in CPB prime followed by infusion at 20 mg/(kg·h) until the
cessation of CPB. Intestinal and blood samples were collected 2 h after CPB for pathological analysis and measurement of
intestinal concentrations of malondialdehyde (MDA), tumor necrosis factor (TNF)-α, interlukin (IL)-6 and activity of
superoxide dismutase (SOD), glutathione (GSH), and glutathione peroxidase (GSH-Px) and serum levels of diamine oxidase
(DAO). Results Evident oxidative stress and pathological damages of the intestines were observed in rats after CPB. NAC
treatment obviously alleviated intestinal damages induced by CPB, decreased the levels of intestinal MDA, TNF-α, IL-6 and
serum DAO and increased activity of SOD, GSH, and GSH-Px in the intestines. Conclusion Perioperative NAC treatment can
alleviate intestinal injury induced by CPB in rats by suppressing oxidative stress and inflammatory response.