血必净注射液对多器官功能障碍综合征大鼠心肌收缩性及相关炎症介质表达的影响

Effect of Xuebijing injection on cardiac contractility and expressions of related inflammatory mediators in rats with multiple organ dysfunction syndrome

目的动态观察血必净注射液对多器官功能障碍综合征（MODS）大鼠心肌收缩性及相关炎症介质表达的影响。方法将144只雄性SD大鼠按随机数字表法分为假手术组（16只）、MODS模型组（64只）、血必净治疗组（64只），MODS模型组及血必净治疗组再按处死大鼠时间点不同分为制模后12、24、36、48h4个亚组，每组16只。观察各组大鼠不同时间点心肌收缩性指标及血浆肿瘤坏死因子-α（TNF-α）、环氧合酶-2（cox-2）、转化生长因子-β1（TGF-β1）及血管性血友病因子（vWF）含量的变化；并于相应时间点处死大鼠，观察大鼠心肌组织病理学变化。结果与假手术组比较，MODS模型组及血必净治疗组各时间点心率（HR）、左室舒张期末压力（LVEDP）及血浆TNF—α、COX-2、TGF-β1、vWF含量均明显增加（均P〈0．05），左室收缩压（LVSP）及左心室压力上升或下降最大速率（±dp／dt max）绝对值均明显下降。与MODS模型组同期比较，血必净治疗组制模后12hHR（次／min）明显下降（480．50±23．50比503．25±25．05），制模后24hLVSP（mmHg，1mm Hg=0．133kPa）、±dp／dt max绝对值（mmHg／s）即明显升高（LVSP：109．25±5．50比96．58±6．49，±dp／dt max：3621．75±67．70比3103．50±13．18，-dp／dt max：4079．66±630．76比3360．17±1052．30），LVEDP（mmHg）于制模后24h明显降低（-3．17±2．67比-0．86±2．46），制模后24hTNF-α（μg/L）、vWF（U／L）即明显降低（TNF-α：51．42±10．89比67．16±15．00，vWF：101．62±19．25比126．22±11．23）；COX-2（μg／L）、TGF-β1（ng／L）于48h显著降低（COX-2：4．83±1．55比6．53±2．21，TGF-β1：2263．70±551．00比2680．07＋613．30，均P〈0．05）。制模后48h心肌病学理改变显示轻度炎症损害。结论血必净注射液能明显改善早期MODS大鼠心肌收缩性，减低血浆炎症因子水平，其调节心肌收缩性的作用可能与调节炎症反应有关。

Objective To dynamically observe the effects of Xuebijing injection on cardiac contractility and expressions of related inflammatory media in rats with multiple organ dysfunction syndrome （MODS）. Methods One hundred and forty-four Sprague-Dawley （SD）male rats were randomly divided into sham operation group （n = 16）, MODS model group （n = 64）and Xuebijing treatment group （n = 64）. The rats in the latter two groups were randomly subdivided into four subgroups ： 12, 24, 36 and 48 hours （ each n = 16） according to the time differences of being killed. The level changes of myocardial contractility indexes, plasma tumor necrosis factor -α （TNF-α）, cyclooxygenase-2 （COX-2）, transforming growth factor-β1 （TGF-β1 ）and von willebrand factor （vWF）were observed in rats in each group at different time points ; the rats were put to death at the corresponding time and the pathological changes of myocardial tissue were observed. Results Compared to sham operation group, at various time points the heart rate （HR）, left ventricular end-diastolic pressure （LVEDP） and the contents of TNF-α, COX-2, TGF-β1 and vWF in plasma in MODS model group and Xuebijing treatment group all increased significantly （all P〈0.05）, the left ventricular systolic pressure （LVSP）and the absolute values of maximum rate of elevating or descending of the left ventricular internal pressure （ ±dp/tit max）all decreased obviously. Compared to the MODS model groups at synchronizing time points, HR （bpm） in Xuebijing treatment group decreased significantly （480.50±23.50 vs. 503.25±25.05） 12 hours after operation, LVSP （mm Hg, 1mm Hg=0.133 kPa）and the absolute values of ±dp/tit max （ram Hg/s）increased significantly 24 hours after operation （LVSP ： 109.25±5.50 vs. 96.58±6.49, ±dp/dt max ：3621.75±67.70 vs. 3103.50±13.18, -dp/dt max ：4079.66±630.76 vs. 3360.17±1052.30）, LVEDP （mm Hg）decreased remarkably （-3.17±2.67 vs. -0.86±2.46）24 hours after operation, the contents of TNF-α （μg/L） and vWF （U/L）in plasma decreased significantly 24 hours after operation （TNF-α： 51.42±10.89 vs. 67.16±15.00, vWF ： 101.62±19.25 vs. 126.22±11.23）, COX-2 （μg/L） and TGF-β1 （ng/L） decreased significantly 48 hours after operation （COX-2 ： 4.83±1.55 vs. 6.53 ± 2.21, TGF- β1 ： 2263.70 ± 551.00 vs. 2680.07± 613.30, both P〈0.05）. The pathological changes of myocardium showed mild inflammatory damage at 48 hours after operation. Conclusios Xuebijing injection can significantly improve cardiac contractility and decrease the plasma levels of inflammatory mediators of MODS rats in early stage, and its regulatory action on cardiac contractility may be related to the modulation of inflammatory reaction.