右美托咪定复合多巴胺对失血性休克大鼠肠道黏膜细胞形态及屏障功能的影响

Effect of dexmedetomidine combined with dopamine on cell morphology and barrier function of intestinal mucosa in rats with hemorrhagic shock

目的观察右美托咪定复合多巴胺对失血性休克大鼠肠道黏膜细胞形态及屏障功能的影响。方法72只Waster大鼠采用随机数字表法分为正常对照组、容量复苏组和研究组,每组24只。正常对照组不予失血性休克处理;容量复苏组在失血性休克后,以6%羟乙基溶粉(HES 200/0.5)与乳酸钠林格液1∶3的比例容量复苏,总量为50 ml/kg;研究组在容量复苏组基础上,静脉给予右美托咪定1μg/kg及多巴胺3μg/kg。3组均在实验开始24 h时采集动脉血做血气分析;光镜下观察HE染色后的肠黏膜组织形态学改变;普通琼脂倾注平板法分析细菌肠道外位移情况。结果研究组PaCO2水平低于容量复苏组,红细胞压积、Hb均高于容量复苏组(均P<0.05);研究组肠道黏膜损伤轻于容量复苏组;研究组肠系膜淋巴结、血液及肝脏的细菌位移发生率均低于容量复苏组(均P<0.05)。结论在常规容量复苏的基础上,右美托咪定复合多巴胺对失血性休克大鼠肠道黏膜上皮细胞及屏障功能有明显保护作用。

Objective To investigate the effect of dexmedetomidine combined with dopamine on the cell morphology and barrier function of intestinal mucosa in rats with hemorrhagic shock.Methods Seventy-two Waster rats were randomly divided into control group,volume resuscitation group or study group with 24 rats in each group.No any treatment for control group,hemorrhagic shock was induced in other two groups.After hemorrhagic shock induced,volume resuscitation group was resuscitated by 1∶3 of 6%hydroxyethyl(HES 200/0.5)and sodium lactate Ringer’s solution with a total volume of 50 ml/kg.The study group was given additional intravenous dexmedetomidine 1μg/kg and dopamine 3μg/kg on the basis of volume resuscitation group.The arterial blood pH,PaCO2,PaO2,hematocrit(Hct)and Hb of rats were measured 24 h after the treatment.Histomorphological changes of intestinal specimens after HE staining were observed under light microscope.The common AGAR plate method was used to analyze the bacterial translocation outside the intestinal tract.Results The PaCO2 level in the study group was lower than that in the volume resuscitation group,the Hct and Hb level in the study group were higher than that in the volume resuscitation group(all P<0.05).Intestinal mucosal injury was less severe in the study group than that in the volume resuscitation group.The incidences of bacterial translocation in mesenteric lymph nodes,blood and liver in the study group were lower than that in the volume resuscitating group(all P<0.05).Conclusion On the basis of conventional volume resuscitation,dexmedetomidine combined with dopamine has protective effect on intestinal mucosal epithelial cells and barrier function in rats with hemorrhagic shock.