- 學位論文
以口服抗生素改善大鼠在大量腸切除併小腸反轉手術後所引起的全身性發炎反應和體重流失
Oral Antibiotics Attenuate Bowel Segment Reversal-Induced Systemic Inflammatory Response and Body Weight Loss in Massively Bowel-Resected Rats
摘要
背景:藉由一個大鼠大量腸切除的動物模式，先前的研究曾指出一段小腸反轉會刺激空腸的增生，但也同時增加細菌轉移的可能性，和使血液循環中的白血球和血清中的介白質-6上升，這些因素可能降低全身的合成代謝，因此，這個研究的目的是研究口服抗生素的給予是否能改善發炎反應和提升小腸反轉手術的效益。 方法:使用雄性Wistar大鼠(約270公克)做百分之七十的腸切除，分成做三公分的小腸段反轉手術組(REV組)、未做小腸反轉手術組(CON組)和假手術組(SHAM組)，手術後REV組中一半的大鼠，給予Clindamycin加Amoxicillin (每天每公斤給予50毫克，ANT組)持續三週。 結果:口服抗生素的給予，明顯改善因大量腸切除合併小腸反轉手術所導致的餵食效率減少，和降低血液循環中的白血球，及血清中的一氧化氮和介白質-6的增加。此外，在大量腸切除合併小腸反轉手術的大鼠，抗生素的給予也明顯增加血清中類胰島素生長因子-I的濃度，減少小腸中細菌的總數和降低空腸增生的傾向。 結論:本研究的結果，建議在大量腸切除合併小腸反轉手術的病人，口服抗生素的給予，也許可以做為一種對於改善發炎反應和促進合成代謝反應的輔助方法。
並列摘要
Background: Using a massively bowel-resected rat model, our previous study demonstrated that small bowel segment reversal stimulates jejunal hyperplasia but may increase the possibility of bacterial translocation and elevate circulating white blood cells and serum interleukin-6 that may reduce whole-body anabolism. The aim of this study is to investigate whether oral antibiotics may attenuate the inflammatory response and may therefore facilitate the beneficial effects of bowel segment reversal. Methods: Male Wistar rats (~270 g) underwent a 70% small bowel resection with (REV group) or without (CON group) a 3-cm small bowel segment reversal or underwent a sham-operation (SHAM group). After the surgery, half of animals in the REV group were given oral clindamycin plus amoxicillin (50 plus 50 mg/kg/day, ANT group) for 3 weeks. Results: Oral antibiotics administration significantly attenuated the decreases in feed efficiency (g of body weight/100 kcal diet) and increases in circulating white blood cells, serum nitric oxide, and interleukin-6 (one-way ANOVA, p < .05) that are associated with bowel segment reversal. In addition, antibiotics significantly increased serum concentrations of insulin-like growth factor-I, significantly decreased the total numbers of bacteria in the intestine, and tended to reduce the extent of jejunal hyperplasia in rats with bowel segment reversal. Conclusion: Our results suggest that oral antibiotics may be used as an adjuvant to attenuate the inflammatory response and to enhance the anabolic responses in massively bowel-resected patients with bowel segment reversal.
參考文獻
延伸閱讀
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