• 四川大學(xué)華西醫(yī)院消化內(nèi)科（成都610041）;

【摘要】目的 綜述應(yīng)激狀態(tài)下腸屏障功能的變化及其機(jī)理的研究進(jìn)展。
方法對(duì)近年來的相關(guān)文獻(xiàn)進(jìn)行分析。
結(jié)果機(jī)體在創(chuàng)傷、嚴(yán)重感染、大手術(shù)和重癥胰腺炎等嚴(yán)重應(yīng)激狀態(tài)下，其腸屏障功能將發(fā)生一系列病理生理的變化，甚至導(dǎo)致全身炎癥反應(yīng)綜合征和多器官功能障礙綜合征或多器官功能衰竭，其變化機(jī)理是一系列神經(jīng)、免疫、內(nèi)分泌機(jī)理相互作用的結(jié)果。
結(jié)論認(rèn)識(shí)應(yīng)激狀態(tài)下腸屏障功能的變化及其機(jī)理對(duì)臨床上治療應(yīng)激引起的腸功能紊亂以及預(yù)防由此所誘發(fā)的嚴(yán)重并發(fā)癥具有重要的臨床意義。

引用本文： 孫敬平,馬洪升. 應(yīng)激狀態(tài)下腸屏障功能的變化及其機(jī)理的研究進(jìn)展. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005, 12(3): 314-316. doi: 復(fù)制

1. Soderholm JD, Perdue MH. Stress and gastrointestinal tract. II. Stress and intestinal barrier function [J]. Am J Physiol Gastrointest Liver Physiol， 2001; 280(1)∶G7.
2. Madara JL. Maintenance of the macromolecular barrier at cell extrusion sites in intestinal epithelium: physiological rearrangement of tight junctions [J]. J Membr Biol, 1990; 116(2)∶177.
3. Meddings JB, Swain MG. Environmental stressinduced gastrointestinal permeability is mediated by endogenous glucocorticoids in the rat [J]. Gastroenterology, 2000; 119(4)∶1019.
4. Santos J, Saperas E, Mourelle M, et al. Regulation of intestinal mast cells and luminal protein release by cerebral thyrotropinreleasing hormone in rats [J]. Gastroenterology, 1996; 111(6)∶1465.
5. Saunders PR, Kosecka U, McKay DM, et al. Acute stressors stimulate ion secretion and increase epithelial permeability in rat intestine [J]. Am J Physiol, 1994; 267(5 Pt 1)∶G794.
6. Castagliuolo I, Lamont JT, Qiu B, et al. Acute stress causes mucin release from rat colon: role of corticotropin releasing factor and mast cells [J]. Am J Physiol, 1996; 271(5 Pt 1)∶G884.
7. Deitch EA. The role of intestinal barrier failure and bacterial translocation in the development of systemic infection and multiple organ failure [J]. Arch Surg, 1990; 125(3)∶403.
8. Barclay GR, Turnberg LA. Effect of psychological stress on salt and water transport in the human jejunum [J]. Gastroenterology, 1987; 93(1)∶91.
9. Wilson LM, Baldwin AL. Environmental stress causes mast cell degranulation, endothelial and epithelial changes, and edema in the rat intestinal mucosa [J]. Microcirculation, 1999; 6(3)∶189.
10. Castagliuolo I, Wershil BK, Karalis K, et al. Colonic mucin release in response to immobilization stress is mast cell dependent [J]. Am J Physiol, 1998; 274(6 Pt 1)∶G1094.
11. Saunders PR, Santos J, Hanssen NP, et al. Physical and psychological stress in rats enhances colonic epithelial permeability via peripheral CRH [J]. Dig Dis Sci, 2002; 47(1)∶208.
12. Alptekin N, Seckin S, DogruAbbasoglu S, et al. Lipid peroxides, glutathione, gammaglutamylcysteine synthetase and gammaglutamyltranspeptidase activities in several tissues of rats following waterimmersion stress [J]. Pharmacol Res, 1996; 34(3-4)∶167.
13. Anup R, Aparna V, Pulimood A, et al. Surgical stress and the small intestine: role of oxygen free radicals [J]. Surgery, 1999; 125(5)∶560.
14. Li LS, Qu RY, Wang W, et al. Significance of changes of gastrointestinal peptides in blood and ileum of experimental spleen deficiency rats [J]. World J Gastroenterol, 2003; 9(3)∶553.
15. Alican I, Kubes P. A critical role for nitric oxide in intestinal barrier function and dysfunction [J]. Am J Physiol, 1996; 270(2 Pt 1)∶G225.
16. Papaconstantinou HT, Chung DH, Zhang W, et al. Prevention of mucosal atrophy: role of glutamine and caspases in apoptosis in intestinal epithelial cells [J]. J Gastrointest Surg, 2000; 4(4)∶416.
  1. 1. Soderholm JD, Perdue MH. Stress and gastrointestinal tract. II. Stress and intestinal barrier function [J]. Am J Physiol Gastrointest Liver Physiol， 2001; 280(1)∶G7.
  2. 2. Madara JL. Maintenance of the macromolecular barrier at cell extrusion sites in intestinal epithelium: physiological rearrangement of tight junctions [J]. J Membr Biol, 1990; 116(2)∶177.
  3. 3. Meddings JB, Swain MG. Environmental stressinduced gastrointestinal permeability is mediated by endogenous glucocorticoids in the rat [J]. Gastroenterology, 2000; 119(4)∶1019.
  4. 4. Santos J, Saperas E, Mourelle M, et al. Regulation of intestinal mast cells and luminal protein release by cerebral thyrotropinreleasing hormone in rats [J]. Gastroenterology, 1996; 111(6)∶1465.
  5. 5. Saunders PR, Kosecka U, McKay DM, et al. Acute stressors stimulate ion secretion and increase epithelial permeability in rat intestine [J]. Am J Physiol, 1994; 267(5 Pt 1)∶G794.
  6. 6. Castagliuolo I, Lamont JT, Qiu B, et al. Acute stress causes mucin release from rat colon: role of corticotropin releasing factor and mast cells [J]. Am J Physiol, 1996; 271(5 Pt 1)∶G884.
  7. 7. Deitch EA. The role of intestinal barrier failure and bacterial translocation in the development of systemic infection and multiple organ failure [J]. Arch Surg, 1990; 125(3)∶403.
  8. 8. Barclay GR, Turnberg LA. Effect of psychological stress on salt and water transport in the human jejunum [J]. Gastroenterology, 1987; 93(1)∶91.
  9. 9. Wilson LM, Baldwin AL. Environmental stress causes mast cell degranulation, endothelial and epithelial changes, and edema in the rat intestinal mucosa [J]. Microcirculation, 1999; 6(3)∶189.
  10. 10. Castagliuolo I, Wershil BK, Karalis K, et al. Colonic mucin release in response to immobilization stress is mast cell dependent [J]. Am J Physiol, 1998; 274(6 Pt 1)∶G1094.
  11. 11. Saunders PR, Santos J, Hanssen NP, et al. Physical and psychological stress in rats enhances colonic epithelial permeability via peripheral CRH [J]. Dig Dis Sci, 2002; 47(1)∶208.
  12. 12. Alptekin N, Seckin S, DogruAbbasoglu S, et al. Lipid peroxides, glutathione, gammaglutamylcysteine synthetase and gammaglutamyltranspeptidase activities in several tissues of rats following waterimmersion stress [J]. Pharmacol Res, 1996; 34(3-4)∶167.
  13. 13. Anup R, Aparna V, Pulimood A, et al. Surgical stress and the small intestine: role of oxygen free radicals [J]. Surgery, 1999; 125(5)∶560.
  14. 14. Li LS, Qu RY, Wang W, et al. Significance of changes of gastrointestinal peptides in blood and ileum of experimental spleen deficiency rats [J]. World J Gastroenterol, 2003; 9(3)∶553.
  15. 15. Alican I, Kubes P. A critical role for nitric oxide in intestinal barrier function and dysfunction [J]. Am J Physiol, 1996; 270(2 Pt 1)∶G225.
  16. 16. Papaconstantinou HT, Chung DH, Zhang W, et al. Prevention of mucosal atrophy: role of glutamine and caspases in apoptosis in intestinal epithelial cells [J]. J Gastrointest Surg, 2000; 4(4)∶416.