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目的:观察姜黄素对脓毒症大鼠肠上皮细胞凋亡的影响及肠黏膜屏障的保护作用。方法:选择87只3月龄雄性SD大鼠,按随机数字表法分为假手术组、模型组、姜黄素组,每组29只。采用盲肠结扎穿孔术(CLP)复制脓毒症大鼠模型;术后10 min假手术组和模型组经腹腔注射二甲亚砜4 mL,姜黄素组经腹腔注射姜黄素200 mg/kg(用4 mL二甲亚砜溶解)。每组随机取其中15只大鼠,于术后2、12、24 h采血,用酶联免疫吸附试验(ELISA)检测血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、D-乳酸、二胺氧化酶(DAO)含量;术后12 h、24 h取大鼠回肠组织,计算回肠组织含水率,并在光镜下观察大鼠回肠组织的病理学变化;采用原位末端缺刻标记试验(TUNEL)检测回肠上皮细胞凋亡情况;同时观察每组剩余14只大鼠术后7 d的存活情况。结果:与假手术组比较,模型组术后各时间点PCT、TNF-α、D-乳酸、DAO含量均升高,PCT、TNF-α含量于术后2 h起与假手术组出现统计学差异〔PCT(μg/L):1.89±0.17比0.10±0.02,TNF-α(ng/L):216.51±1.47比85.25±8.20,均n P<0.01〕,而D-乳酸、DAO含量于术后12 h起与假手术组出现统计学差异〔D-乳酸(mg/L):40.53±7.76比11.29±1.28,DAO(ng/L):1 120.40±302.35比330.02±81.28,均n P<0.01〕。与模型组比较,姜黄素组术后各时间点PCT、TNF-α、D-乳酸、DAO含量均降低,并均于术后12 h起与模型组出现统计学差异〔PCT(μg/L):5.37±0.44比8.67±0.64,TNF-α(ng/L):211.12±4.31比313.30±18.46,D-乳酸(mg/L):29.74±1.41比40.53±7.76,DAO(ng/L):810.71±201.41比1 120.40±302.35,均n P<0.05〕,术后12 h、24 h回肠组织含水率均明显降低〔分别为(68.34±0.68)%比(70.55±0.87)%和(69.41±0.59)%比(71.69± 0.87)%,均n P<0.05〕。光镜下可见,假手术组术后12 h和24 h回肠组织绒毛结构基本正常;模型组术后12 h回肠绒毛萎缩、增宽水肿、高度下降,术后24 h绒毛水肿、萎缩进一步加重;姜黄素组术后12 h和24 h回肠绒毛水肿、高度等结构受损程度较模型组减轻。模型组回肠组织绒毛上皮细胞凋亡数较假手术组明显增加(个:25.48±6.10比4.00±2.04),姜黄素组细胞凋亡计数较模型组明显减少(个:15.48±3.75比25.48±6.10),差异均有统计学意义(均n P0.05)。n 结论:姜黄素可通过抑制脓毒症大鼠肠上皮细胞凋亡,从而保护肠黏膜屏障功能。“,”Objective:To study the effect of curcumin on enterocyte apoptosis and its protective effect on intestinal mucosal barrier in septic rats.Methods:Eighty-seven 3-month male Sprague-Dawley (SD) rats were divided into Sham group, model group and curcumin group by random number table method, with 29 rats in each group. The septic rat model was reproduced by cecal ligation and puncture (CLP). 4 mL dimethyl sulfoxide solution were intraperitoneally injected in both Sham group and model group, 200 mg/kg curcumin dissolved by 4 mL dimethyl sulfoxide solution were intraperitoneally injected in curcumin group 10 minutes after operation. The blood samples (15 rats in each group) were collected 2, 12, 24 hours after operation, and the levels of serum procalcitonin (PCT), tumor necrosis factor-α(TNF-α), D-lactic acid and diamine oxidas (DAO) were tested by enzyme linked immunosorbent assay (ELISA). The ileum tissues were collected 12 hours, 24 hours after operation in three groups, water content was tested by weighting, pathologic structure was observed by light microscope, the enterocyte apoptosis was tested by terminal deoxynucleotidyl transferase-mediated dUTP-nick end labeling method (TUNEL). The 7-day survival rate was observed in three groups (14 rats in each group).Results:The serum levels of PCT, TNF-α, D-lactic acid and DAO were higher in model group at 2, 12, 24 hours after operation than those in Sham group, PCT, TNF-α levels were significantly higher in model group than those in Sham group 2 hours after operation [PCT (μg/L): 1.89±0.17 vs. 0.10±0.02, TNF-α (ng/L): 216.51±1.47 vs. 85.25±8.20, bothn P < 0.01], D-lactic acid, DAO levels were significantly higher in model group than those in Sham group 12 hours after operation [D-lactic acid (mg/L): 40.53±7.76 vs. 11.29±1.28, DAO (ng/L): 1 120.40±302.35 vs. 330.02±81.28, both n P < 0.01]. Compared with model group, the levels of serum PCT, TNF-α, D-lactic acid and DAO were lower in curcumin group 2, 12, 24 hours after operation, the statistical difference appeared from 12 hours after operation [PCT (μg/L): 5.37±0.44 vs. 8.67±0.64, TNF-α(ng/L): 211.12±4.31 vs. 313.30±18.46, D-lactic acid (mg/L): 29.74±1.41 vs. 40.53±7.76, DAO (ng/L): 810.71±201.41 vs. 1 120.40±302.35, all n P < 0.05], curcumin group had lower water content in ileum tissues 12 hours, 24 hours after operation [(68.34±0.68)% vs. (70.55±0.87)%, (69.41±0.59)% vs. (71.69±0.87)%, both n P < 0.05]. The pathologic structures of intestinal villus were normal in Sham group, however, in model group intestinal villus were atrophic, edematous and shorten 12 hours after operation, it was further exacerbated 24 hours after operation. Compared with model group, the pathologic structures of intestinal villus in curcumin group were relived 12 hours, 24 hours after operation. The number of apoptotic enterocytes were significantly increased in model group compared with Sham group 24 hours after operation (cells: 25.48±6.10 vs. 4.00±2.04, n P < 0.05), and the number of apoptotic enterocytes was lower in curcumin group than that in model group at the same time (cells: 15.48±3.75 vs. 25.48±6.10), the difference was statistically significant (both n P 0.05).n Conclusion:Curcumin can protect the intestinal mucosal barrier by inhibiting enterocyte apoptosis in septic rats.