七氟烷预处理对失血性休克猪血浆肠脂肪酸结合蛋白、D-乳酸浓度和细菌移位的影响

Effect of sevoflurane preconditioning on the concentration of plasma I-FABP and Dlactate and bacterial translocation in hemorrhagic shock pigs

目的探讨七氟烷预处理对失血性休克猪血浆肠脂肪酸结合蛋白(I-FABP)、D-乳酸浓度和细菌移位的影响。方法巴马小型猪24头,雌雄不拘,采用随机数字表法均分为对照(C)组、失血性休克(S)组和七氟烷预处理(Sev)组。Sev组吸入七氟烷并保持2%呼出浓度30 min,C组和S组吸入空气30 min。之后S组和Sev组制备失血性休克模型。分别于麻醉前(T0)、休克后30 min(T1)、1 h(T2)、1.5 h(T3)、2 h(T4)、3 h(T5)和4 h(T6),应用ELISA法测定各组血浆D-乳酸和I-FABP含量。于T6时点取肠组织行HE染色,取下腔静脉血、肠系膜淋巴结及肝、肺、肾、脾组织行细菌培养,并计算远隔器官细菌移位率。结果 Sev组血浆D-乳酸、I-FABP浓度和远隔器官细菌移位率均明显低于S组(P<0.05),明显高于C组(P<0.05)。HE染色显示,S组肠黏膜损伤严重,Sev较之明显减轻,C组肠黏膜结构正常。结论七氟烷预处理可显著降低失血性休克猪血浆I-FABP、D-乳酸浓度和细菌移位,对肠黏膜屏障具有保护作用。

Objective To investigate the effect of sevoflurane preconditioning on the concentration of plasma I-FABP and D-lactate and bacterial translocation in hemorrhagic shock pigs. Methods Twenty four Bama miniature pigs with male and female informal were equally divided into control（ C） group,hemorrhagic shock（ S） group and sevoflurane precondition（ Sev） group using random number table method. Pigs from group Sev inhaled 2% sevoflurane30 min while animals from group C and group S inhaled air. Afterwards,the hemorrhagic shock model was established in group S and group Sev. The concentration of plasma I-FABP and D-lactate were measured using ELISA method before anesthesia（ T0） and at 30 min（ T1）,1 h（ T2）,1. 5 h（ T3）,2 h（ T4）,3 h（ T5）,4 h（ T6） after the hemorrhagic shock model was made. The jejunum sample was obtained for HE staining at T6,and the inferior vena venous blood,mesenteric lymph nodes,live,lung,kidney and spleen samples were obtained for bacterial culture at the same time. Afterwards,the bacterial translocation rate was calculated. Results The concentration of plasma D-lactate,IFABP and the rate of bacterial translocation in group Sev were lower than those of group S（ P 0. 05） and higher than those of group C（ P 0. 05）. HE staining showed obvious intestinal mucosa injury in group S. The injury was alleviated in group Sev while the tissue structure in group C was normal. Conclusion Sevoflurane preconditioning can significantly decrease the concentration of plasma I-FABP,D-lactate and bacterial translocation,and has gut mucosal barrier protection effect on hemorrhagic shock pigs.