乌司他丁预防重症中暑早期肠黏膜损害的实验研究

Effects of ulinastatin on intestinal mucosal barrier in patients with severe heatstroke

目的探讨乌司他丁(UTI)对重症中暑肠黏膜屏障功能的影响。方法 24只SPF级雄性BALB/c小鼠,随机分为对照组、42℃热打击组、低剂量(5000U/kg)UTI组及高剂量(10 000U/kg)UTI组,每组6只。观察各组动物小肠病理组织形态学变化、血浆炎症因子水平、肠道细菌移位率、血浆二胺氧化酶(DAO)活性和D-乳酸浓度。采用KaplanMier法和Log-R ank检验进行生存分析。结果与热打击组比较,U TI组小肠黏膜绒毛水肿、坏死和脱落现象明显减轻,炎症细胞浸润及细菌移位减少,血浆DAO活性及D-乳酸浓度也明显降低,尤其是大剂量组改善作用更为明显,各组比较差异有统计学意义(P<0.05)。生存分析显示,UTI组中位生存时间显著延长(χ2=43.27,P=0.000)。结论 UTI对重症中暑早期肠黏膜损害具有保护作用。

Objective To observe the effect of ulinastatin （UTI） on severe heatstroke-induced intestinal mucosal barrier function. Methods The SPF male BALB/c mice are randomly divided into control group that in which the mice were not exposed to heat stress 42℃ heat-stress group, lower-dose UTI group （5000U/kg） and higher-dose UTI group （10 000U/kg） before 42℃ heat stress. The morphological change of the small intestinal pathological tissue, the rate of intestinal bacterial translocation, and inflammatory cytokines level, diamine oxidase （DAO） activity and D-lactic acid concentration in plasma were observed. Survival curve was described by Kaplan-Meier survival analysis and log-rank test. Results Compare to control group, the UTI treatment significantly alleviated villous edema, necrosis and of intestinal mucosa, infiltration of inflammatory cells was significantly reduced and the bacterial translocation, DAO activity and D-lactic acid concentration were also obviously decreased, especially in higher- dose group, There were statistically significant differences between treatment and control groups （P〈0.05）. Conclusion UTI has a protective effect against the damage of intestinal mucosal during the early stage of severe heatstroke.