升降散对脂多糖诱导脓毒症大鼠心肌损伤的保护作用

Protective effect of Lifting Powder against the myocardial injury induced by LPS in septic rats

目的探讨升降散对脂多糖（LPS）诱导脓毒症大鼠所致心肌损伤的保护作用。方法采用腹腔注射LPS法构建急性脓毒症大鼠模型，大鼠按随机数字表法随机分组进入实验。正常组（n=6），脓毒症模型组（n=18），中药组（n=18），除正常组不注射LPS外，其余组均步骤同模型组。中药组于造模前72h开始至造模后6h用升降散灌胃，1次／12h，共8次。正常组和脓毒症模型组给予等量生理盐水灌胃。并于造模后12、24、48h采集大鼠血清及心肌组织匀浆，观察心肌组织切片病理改变（造模后12h），依次按各时间点测定白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、心肌肌钙蛋白-I（cTnI）及脑尿钠肽（BNP）等。结果造模后12h，正常组心肌细胞结构正常；模型组心肌纤维部分断裂、溶解，心肌间质明显水肿，炎症细胞浸润；中药组心肌纤维结构完整，排列不规则，间质无明显水肿，偶见炎症细胞浸润。模型组及中药组IL-1、IL-6、TNF-α、cTnI、BNP水平均较正常组升高（P〈0．01）；中药组1L-1和IL-6水平在12h时低于模型组（P〈0．05），TNF-α水平在24h（P〈0．01）及48h（P〈0．05）低于模型组，BNP、cTnI水平在各时间点均低于模型组（P〈0．01），中药组24h及48hBNP、cTnI水平较12h明显降低（P〈0．01）。结论升降散能减轻脓毒症大鼠心肌损害，改善大鼠心功能，其机制可能与抑制炎症反应有关。

Objective To investigate the protective effects of modified powder on myocardial injury induced by LPS in septic rats. Methods The acute septic rat model was constructed by intraperitoneal injection of LPS. The rats were randomly divided into the normal group （ n = 6） , the sepsis model group （n = 18） and the Chinese medicine group （n = 18） , except the normal group were not injected LPS, the rest of the groups were the same as the model group. The Chinese medicine group was started to disperse the stomach with Lifting Powder 72 h before and 6 h after modeling, 1 time/12 h, 8 times totally. The serum and heart homogenates were collected 12 h, 24 h, 48 h after modeling, to observe the change of pathological myocardial tissue （ 12 h after modeling） , determination of interleukin 1 （ IL - 1 ） , interleukin 6 （ IL - 6） , tumor necrosis factor - α （ TNF - α） , cardiac troponin I （cTnl） and brain natriuretic peptide （BNP） level. Results Rats in normal group showed myocardial cell structure 12 h after modeling, but rats in model group showed part of the fracture, myocardial fiber dissolution, myocardial interstitial edema, inflammatory cell infiltration. Rats in traditional Chinese medicine group showed myocardial fiber structure integrity, irregular arrangement, no obvious interstitial edema, inflammatory cell infiltration occasionally. In the model group and Chinese medicine group, IL -1, IL - 6, TNF - α, cTnI, BNP levels increased compared with normal group increased （ P 〈 0.01 ） ; traditional Chinese medicine group compared with the model group, IL - 1 and IL - 6 levels were lower than the model group at 12 h （P〈0.05）, TNF- α levels in the 24 h （P〈0.01） and 48 h （P〈 0.05） were lower than those of model group; the cTnI, BNP level of Chinese medicine group in each time period were lower compared with the model group （P 〈 0.01 ）, In Chinese medicine group, 24 h, 48 h BNP, cTnI levels were significantly lower than that in 12 h （ P 〈 0.01 ）. Conclusion The Lifting Powder can reduce the myocardial damage and improve the cardiac function in sepsis rats, and the mechanism may be related to the inhibition of inflammatory reaction.