高渗盐羟乙基淀粉对失血性休克大鼠回肠粘膜HMGB1及凋亡的影响

Effect of Hypertonic Sodium Chloride Hydroxylethy Starch on HMGB1 and Apoptosis in Rats with Hemorrhagic Shock

目的探讨高渗盐羟乙基淀粉对失血性休克大鼠肠道缺血再灌注损伤的影响。方法本研究将60只SD大鼠制作成失血性休克模型,随机分为正常对照组(N组)、乳酸林格液复苏组(RL组)、羟乙基淀粉复苏组(HES组)、高渗盐联合羟乙基淀粉复苏组(HSH组),每组15只。采用改良Wigger's法制作失血性休克动物模型。测量复苏2 h后大鼠平均动脉压(mean arterial blood pressure,MAP),光镜下观察肠组织病理学变化,免疫组化检测肠组织HMGB1,末端脱氧核苷酸转移酶介导的原位末端标记法(TUNEL)检测检测小肠黏膜细胞凋亡情况。结果病理切片HE染色示在保护小肠粘膜损伤方面RL组和HES组显著低于N和HSH组(P<0.01)。HMGB1表达测定N组、HSH组明显比RL组和HES组低(P<0.05)。N组、RL组、HES组、HSH组细胞凋亡检测两两比较均有差异(P<0.05)。结论与N组、RL组、HES组液体相比HSH组可明显减轻大鼠回肠黏膜的损伤,降低HMGB1的表达,减少细胞凋亡,有助于更好地保护机体细胞和维持器官功能状态。

Objective To investigate the effect of hypertonic saline - hydroxyethyl starch on ischemia - reperfusion injury of rats＇ intestine in hemorrhagic shock. Methods Rat models with hemorrhagic shock were established in 60 SD rats by the method of Wig- get＇ s. The rats were divided into The noemal control group （ N group）, ringer resuscitation group （ RL group） , hydroxyethyl starch resuscitation group （HES group） and hypertonic saline （7.5%） combined with hydroxyethyl starch resuscitation group （HSH group）, with 15 rats in each group. MAP at different time points were recorded, the ultrastructure in intestine tissue was observed by electron microscope, immunochemistry staining was used to detect the expression of HMGB1 on intestinal mucosa and the apoptosis of intestinal mucosa was tested. Results Pathological examination （ HE staining） showed the HSH group and N group were significantly inferior in terms of protecting intestinal mucosal injury to RL group and HES group （ P 〈 0. 01 ）. HMGB1 detect showed the HSH group and N group were significantly lower than RL group and HES group （ P 〈 0. 05 ）. There was significant difference in apoptosis of intestinal mu- cosa in rats of RL, HES, N and HSH groups after hemorrhagic shock and resuscitation （P 〈0. 05）. Conclusion HSH can help to protect intestinal mucosa, suppress the expression of HMGB1 and reduce apoptosis, which would be a better way to protect the body ceils and maintain organ function.