骶神经电刺激对脊髓损伤大鼠肠黏膜机械屏障的保护作用

目的：观察骶神经电刺激对脊髓损伤大鼠肠黏膜机械屏障的保护作用。方法：56只Wistar大鼠分7组（n=8）：正常组、急性完全性脊髓损伤（SCI）组和骶神经电刺激组（按24、48、72h各8只）。进行内毒素测定；肠系膜淋巴结、肝脏、脾脏菌培养；肠道形态学观察；紧密连接蛋白zo-1的蛋白表达测定。结果：对照组肠黏膜不同程度损伤；肠道上皮细胞及细胞间连接破坏；内毒素血症和细菌移位明显。实验组肠黏膜得到改善，内毒素水平下降且细菌移位减少。ZO-1蛋白表达无统计学差异。对照组ZO-1的分布出现不同程度的散乱、排列不规则，实验组分布得到改善。结论：骶神经电刺激可促肠蠕动、排肠内容物、减少肠道菌群数量，保护肠黏膜上皮细胞及紧密连接的机械屏障，减少细菌移位和内毒素血症。

The protective effects of sacral nerve electrostimulation on intestinal mucosal mechanical barrier in rats with spinal cord injury

Objective： To study the protective effects of sacral nerve root electrostimulation on intestinal mechanical barrier in rats with spinal cord injury（SCI）. Methods： Fifty six Wistar rats were divided into normal group, SCI control group and SCI group with sacral nerve root electrostimulation（8 rats in each subgroup at 24,48,72 h after spinal cord injury）. The following experiments were performed respectively in rats from the 3 groups： bacteria culture from intestinalmesentery lymph nodes, liver, spleen, intestinal morphology observation and detection the protein expression level of ZO-1. Results： The intestinal mucosa appeared different degree of damage in SCI control group; cell-cell con- necfions between intestinal epithelial cells were destroyed; Endotoxin levels in blood and the number of bacterial translocation increased obvi- ously. Sacral nerve stimulation was found toimprove the intestinal mucosal, reduce the endotoxin content in the blood to normal level and the decrease the incidences of bacterial translocation of the gut origin. The expression of tight junction protein ZO-1 of rat intestinal tissue had no statistical differences among the 3 groups. On the other hand, the distribution of tight junction protein ZO- 1 appeared different degrees of scat- tered and irregular in the control group while that in the experimental group appeared different degree of improvement as determined by the im- munohistochemistry of rat intestinal tissue. Conclusion： sacral nerve root electrostimulation can rehabilitate the peristalsis of denervated colon, promote defeacation and decrease bacterial amount, protection of the intestinal mechanical barrier between intestinal epithelial cells and tight junction, reducing the endotoxin content in the blood and suppressing bacterial translocation from the gut.