摘要目的 了解短肠综合征大鼠残存小肠自发性节律性收缩运动及卡巴胆碱诱导小肠平滑肌肌条收缩反应的变化趋势,并探讨腹腔注射胰高血糖素多肽-2 (GLP-2)对短肠综合征大鼠残存小肠术后代偿反应的改善作用及其机制.方法 通过外科手术方法建立动物模型,40只SD大鼠随机分成4组分别为假手术组(设为对照组)、SBS1W组、SBS2W组、G-SBS1W组,G-SBS1W组腹腔注射125μg·kg-1·d-1的GLP-2溶液(20μg/ml),每天2次,连续5d.苏木精-伊红(HE)染色研究小肠全壁形态学改变；电镜观察黏膜上皮及平滑肌细胞的超微结构改变；环形平滑肌肌条实验研究其自发性节律性收缩变化规律及卡巴胆碱诱导肌条收缩反应的变化趋势.结果 短肠综合征大鼠术后1周残存小肠肠管显著扩张；HE染色显示SBS1W组大鼠小肠黏膜上皮增生明显,平滑肌层肥厚、平滑肌增生；环形平滑肌肌条实验提示平滑肌自发性节律性收缩紊乱、幅度不规则、频率变慢；短肠综合征大鼠术后1周卡巴胆碱诱导肌条收缩反应明显增强,术后2周后基本恢复假手术组水平；G-SBS1W组术后1周黏膜上皮进一步代偿,而平滑肌肥厚、增生不明显,环形平滑肌肌条实验及卡巴胆碱反应曲线与假手术组相似.结论 短肠综合征大鼠术后1周残存小肠动力发生动力改变,GLP-2能明显改善短肠综合征大鼠残存小肠的形态及功能.

abstractsObjective In this study,we aim to investigate the spontaneous contractile function of remnant ileum and the effect of carbachol on contractile function in rats after massive small bowel resection andto further study the effects of GLP-2 on the function of remaining bowel in rats with short bowel syndrome(SBS).Methods A model of SBS by surgical induction was designed.28 male Sprague Dawley rat underwent a 75％ proximal SBR or sham operation and divded into four groups (SBS1W; SBS2W; G-SBS1W; Sham).G-SBS1W rats received 125 μg·kg-1·d-1GLP-2 intra-peritoneally twicw daily for 5 days.The remnant ileum was harvested on the day of 7 and 14.Morphological changes were recorded by HE staining (villus height,circumference,and ISM thickness) and TEM (microvillus,ultrastructure of the smooth muscle cells).Contractility was measured by attaching the distal ileum strips to SMUP-E biological signal processing transducers and exposed to varying doses of carbachol.Results Significant expansion of small bowel was observed in rats with SBS.Smooth muscle proliferation was found by HE staining.Muscle strips test indicated that disordered spontaneous rhythmic contraction,with irregular amplitude and slow frequency occurred in intestinal smooth muscle.Carbachol increased the contractile function of remaining bowel at 1week and induced recovery to normal at 2 weeks.In G-SBS1W group,intestinal appearance was similarto sham group.Conclusions Contractile function of remnant ileum changed in rats with SBS1W.Carbachol increased the contractile function after 1week of surgery.Exogenous supplemented GLP-2 could recover and maintain the function of intestinal ileum in rats with SBS.