中文摘要：

目的观察大鼠肝缺血-再灌注后肠黏膜屏障功能的变化，并探讨其对肠源性细菌移位的影响。方法64只成年健康雄性SD大鼠，随机分为对照组和实验组，每组32只。实验组用无创微血管钳于肝门部夹闭肝动脉、门静脉和胆总管，45min后去除血管钳，分别在全肝血流阻断45min后再灌注即刻（0h）、再灌注1h、再灌注2．5h、再灌注4h共4个时间点采集标本，测定血浆肿瘤坏死因子α（TNF-α）、D-乳酸水平以及肠黏膜中丙二醛、特异性分泌型免疫球蛋白（sIgA）的含量；观察回肠壁组织病理学改变，取肠系膜淋巴结（MLN）、肝、脾、肺、肾及回肠组织匀浆进行细菌培养和鉴定。对照组仅分离门静脉、肝动脉及胆总管，不行血管阻断。结果实验组在再灌注即刻及再灌注后血浆TNF-α的水平不断升高，再灌注后的TNF-α的水平明显高于再灌注即刻（P〈0．05）；D-乳酸的水平也明显高于对照组，但组内不同时间点比较，差异无统计学意义；肠黏膜中丙二醛的含量明显高于对照组（P〈0．05），再灌注后的含量明显高于再灌注即刻（P〈0．05）；而sIgA在再灌注即刻及再灌注后明显低于对照组（P〈0．05）。随着肝缺血-再灌注时间的延长，实验组肠黏膜的病理改变逐渐加重。实验组在再灌注即刻在MLN、肝、脾、肺及肾组织中可培养出细菌，随着再灌注后时间的延长，实验组中MLN、肝、脾、肺及肾组织中检出细菌的动物数明显增多（P〈0．05），培养出的细菌与回肠的优势菌分布一致。结论肝缺血-再灌注损伤导致肠屏障功能损害，且引起肠道菌群易位。

英文摘要：

Objective To investigate the change of the intestinal barrier after hepatic ischemiareperfusion and to study its relationship with the bacteria translocation. Methods A model of liver ischemia-reperfusion injury was established. Sixty-four Sprague-Dawley adult male rats were randomly allocated into two groups： the control group （n = 32） and the experimental group （n = 32）. Each group was subdivided randomly into 4 subgroups （n = 8） according to different experimental time points as follows： instantly （0 h） reperfusion following ischemia 45 min, 1 h reperfusion following ischemia 45 rain, 2. 5 h reperfusion following ischemia 45 min and 4 h reperfusion following ischemia 45 rain. The levels of tumor necrosis factor-α （TNF-α） and D-lactate in portal vein blood and malondialdehyde （MDA） and secretory immunoglobulin A （slgA） in intestinal mucosa were detected at different time points respectively. The pathologic morphological change of ileum intestinal mucosa was observed under a light microscope. Tissue samples from the mesenteric lymph nodes, lung, liver, spleen, kidney and ileum were taken for bacteriologic cultures. Results Compared with the control group at different time points, the levels of D-lactate, TNF-α and MDA in the experimental group were significantly increased （P〈0. 05）, while the level of slgA was significantly decreased （P〈0. 05）. Compared with the 0 h group, the levels of TNF-α and MDA in 1 h, 2. 5 h, 4 h groups in the experimental group were significantly increased （P〈0. 05）. The histologic damages of ileum intestinal mucosa were observed at different time points respectively. There was different degree damage in the experimental group. Bacterial translocation was significantly increased in the experimental group. And the distribution of the dominant bacteria in mesenteric lymph nodes, lung, liver, spleen and kidney was similar to ileums. Conclusion The liver ischemia-reperfusion could damage intestinal barrier and induce bacteria translocatio