【摘要】：目的研究內(nèi)毒素親和吸附劑(EAA)對創(chuàng)傷失血性休克大鼠腸損害及炎癥因子水平的影響。方法選取SD大鼠,按照體重隨機(jī)分為5組:正常組、模型組和低中高3個劑量實(shí)驗(yàn)組,每組10只。通過創(chuàng)傷和放血構(gòu)建創(chuàng)傷失血性休克大鼠模型。在建模前30 min,低中高3個劑量(EAA 5,10,15 m L+15,10,5m L 0.9%Na Cl)實(shí)驗(yàn)組分別于大鼠消化道內(nèi)灌注。用HE染色法觀察大鼠腸道絨毛形態(tài)變化以及腸黏膜損傷程度。復(fù)蘇后4,8,16 h對大鼠的內(nèi)毒素、一氧化氮(NO)、腫瘤壞死因子α(TNF-α)水平進(jìn)行檢測。結(jié)果與空白組0.03±0.01比較,模型組的腸黏膜損傷指數(shù)為5.41±2.56,差異有統(tǒng)計學(xué)意義(P0.05)。復(fù)蘇4 h后,與模型組比較,高、中、低3個劑量實(shí)驗(yàn)組的大鼠腸黏膜損傷指數(shù)分別為3.45±0.75,2.53±0.68,2.02±0.53,差異均有統(tǒng)計學(xué)意義(均P0.05)。與空白組比較,模型組大鼠的血清內(nèi)毒素、NO、TNF-α水平分別為(456.52±21.56)pg·m L~(-1),(108.41±9.56)ng·m L~(-1),(77.58±10.65)ng·m L~(-1),差異均有統(tǒng)計學(xué)意義(均P0.05)。復(fù)蘇4 h后,高、中、低3個劑量實(shí)驗(yàn)組的大鼠內(nèi)毒素、NO、TNF-α的水平分別為(280.41±15.42),(254.63±17.56),(221.53±13.53)pg·m L~(-1);(90.43±8.42),(63.54±7.53),(49.52±8.41)ng·m L~(-1);(77.58±10.65),(62.58±5.12),(42.51±4.53)ng·m L~(-1)。與模型組比較,3個劑量實(shí)驗(yàn)組的大鼠內(nèi)毒素、NO水平差異均有統(tǒng)計學(xué)意義(均P0.05);而TNF-α水平只有中低2個劑量實(shí)驗(yàn)組差異均有統(tǒng)計學(xué)意義(均P0.05)。結(jié)論低濃度EAA能夠有效緩解失血性休克引起的應(yīng)激反應(yīng),降低炎癥因子水平,從而保護(hù)大鼠腸功能。
[Abstract]:Objective to study the effects of endotoxin affinity adsorbent (EAA) on intestinal damage and inflammatory factors in rats with traumatic hemorrhagic shock. Methods Sprague-Dawley rats were randomly divided into 5 groups according to their body weight: normal group, model group and low, medium and high dose groups, with 10 rats in each group. The rat model of traumatic hemorrhagic shock was established by trauma and bloodletting. 30 minutes before modeling, the experimental group was perfused in the digestive tract of rats at three doses (EAA 5: 1015m / L, 1015m / L, 105m / L) and NaCl (0.9m / L), respectively. The morphological changes of intestinal villi and the degree of intestinal mucosal injury were observed by HE staining. The levels of endotoxin, nitric oxide (no) and tumor necrosis factor- 偽 (TNF- 偽) in rats were measured at 4 and 8 hours after resuscitation. Results compared with the blank group (0.03 鹵0.01), the intestinal mucosal injury index in the model group was 5.41 鹵2.56, the difference was statistically significant (P0.05). After 4 hours of resuscitation, compared with the model group, the intestinal mucosal injury index of the experimental groups with high, middle and low doses was 3.45 鹵0.75V 2.53 鹵0.68 鹵2.02 鹵0.53, respectively. The difference was statistically significant (P0.05). Compared with the blank group, the serum levels of TNF- 偽 in the model group were (456.52 鹵21.56) pg m / L ~ (-1), (~ (-1) 鹵9.56) ng m L ~ (-1), (77.58 鹵10.65) ng m L ~ (-1), respectively (P0.05). 4 h after resuscitation, the levels of TNF- 偽 were (280.41 鹵15.42), (鹵17.53) pg m L-1); (90.54 鹵7.53), (49.52 鹵8.41) ng m L-1); (77.58 鹵10.65), (62.58 鹵5.12), (42.51 鹵4.53) ng m L ~ (-1) respectively) in the three experimental groups. Compared with the model group, the levels of endotoxin and no in the three dose groups were significantly different (P0.05), while the levels of TNF- 偽 in the middle and low dose groups were statistically significant (P0.05). Conclusion low concentration EAA can effectively relieve the stress response induced by hemorrhagic shock and reduce the level of inflammatory factors, thereby protecting the intestinal function of rats.
【作者單位】： 開灤總醫(yī)院麻醉科;
【基金】：河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計劃基金資助項(xiàng)目(ZD20140064)
【分類號】：R965

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