An experimental study on monitoring of barrier function of small intestine

doi:10.3969/j.issn.1009-4237.2001.02.011

Abstract：Objective　To establish a rapid and sensitive method for clinical monitoring of barrier function of small intestine in patients with trauma.Methods　Thirty-two male goats were randomly divided into 3 groups which were trauma-hemorrhagic shock group(group H,n=6),trauma-endotoxemia group(group E,n=6) and trauma-hemorrhagic shock plus endotoxemia group(group M,n=20 ). The animal model proved to be a good simulation of trauma, bowel ischemia /reperfusion and sepsis in patients. Plasma DAO , intestinal mucosa pH (pHi) and the ratio of lactulose/mannitol (L/M) were determined, and comparative analysis was performed in accordance with plasma LPS , TNFα and morphological alteration.Results　The activity of DAO increased greatly at the end of shock stage in group H and peaked twice in group M. L/M ratio was significantly higher in group M than that in group E.The pHi decreased progressively after LPS infusion. The change in plasma level of DAO was highly correlated with that of L/M and pHi, and was in accordance with the morphological changes. The change in plasma level of DAO, L/M and pHi was highly correlated with that of LPS and TNFα.Conclusion　Both traumatic ischemia-reperfusion injury and LPS infusion will lead to temporal and reversible impairment of gut barrier function. The status of gut barrier function can be reflected by DAO, L/M and pHi. Our investigation indicates that DAO is the most sensitive parameter for the prediction of gut barrier function and thus is clinically valuable.