两种液体复苏对失血性休克大鼠细菌移位及肠道炎症反应的影响

Comparison of effects of two kinds of fluid for resuscitation on bacterial translocation and inflammation of small intestine in rats with hemorrhagic shock

目的探讨复方氯化钠溶液(林格液,RS)和质量分数为6%的中分子羟乙基淀粉溶液(HES)对失血性休克大鼠细菌移位及肠道炎症反应的影响。方法50只健康雄性SD大鼠按随机数字表法分为假手术组(SHA组,n=10)、RS组(n=20)、HES组(n=20),RS组和HES组制备可控性失血性休克模型。分别于液体复苏后1 h和24 h处死大鼠,检测和比较各组大鼠细菌移位、肠组织肿瘤坏死因子α(TNFα)及髓过氧化物酶(M PO)活性的变化,并进行病理学检查。结果HES组和RS组在死亡率、放血量、病理学检查方面没有明显差别。与SHA组比较,HES组和RS组在菌落计数和TNFα方面明显升高,其中HES 1 h组比RS1 h组明显升高,HES 24 h组比RS24 h组明显下降。与SHA组比较,HES 1 h组和RS 1 h组的M PO活性明显升高,HES 24 h组和RS 24 h组M PO活性没有明显差别。结论RS能明显改善复苏后1 h的肠道功能,HES能明显改善复苏后24 h的肠道功能。

Objective To investigate the effects of Ringer＇s solution （RS） or 6% hydroxyethyl saline （HES） on bacterial translocation and inflammation of the small intestine in rats with hemorrhagic shock. Methods Fifty healthy male SD rats were randomly divided into the sham group （SHA group, n= 10）, the Ringer＇s solution group （RS group, n=20） and 6% hydroxyethyl saline group （HES group, n =20）. Controlled hemorrhagic shock model was reproduced in RS and HES groups. Bacterial translocation to the liver, the .content of tumor necrosis factor -α（TNF -α） in intestinal tissue, and the myeloperoxidase （MPO） activity in the intestinal tissue were determined and compared among the groups, and the pathologic changes in the small intestine were observed. Results The mortality rate, bleeding volume and Chiu＇s scores were same in HES and RS groups （all P）〉0. 05）. Compared to SHA group, bacterial count and TNF -α level were increased significantly in HES and RS groups, and they were higher at 1 hour and lower at 24 hours in HES group than those in RS group. Compared to the SHA group, MPO activity increased at 1 hour in RS and HES groups, but no significant difference between the groups was found at 24 hours. Conclusion RS prevents compromise of the intestinal barrier function better than the HES at 1 hour after fluid resuscitation. However, HES seems to be better in protecting the intestinal barrier function compared with RS at 24 hours after fluid resuscitation.