七氟烷后处理对失血性休克巴马小型猪肝功能和BHMT、IL-6、TNF-α的影响

Effect of post-treatment with sevoflurane on liver function and BHMT,IL-6,TNF-αin Bama minipigs with hemorrhagic shock

目的通过观察七氟烷后处理对失血性休克巴马小型猪肝功能及血清甜菜碱高半胱氨酸甲基转移酶(BHMT)、Lac、IL-6和TNF-α水平的影响,旨在探讨七氟烷对其肝脏损伤的保护作用及可能机制。方法巴马小型猪24头,随机分为3组,每组8头,分别为假手术组(Sham组)、失血性休克组(HS组)及七氟烷后处理组(Sev组)。HS组麻醉后建立失血性休克模型;Sev组于建立失血性休克模型后,给予2%七氟烷吸入30 min。三组于实验前(T0)、休克后30 min(T_1)、休克后1 h(T_2)、休克后1.5 h(T_3)、休克后2 h(T_4)、休克后3 h(T_5)及休克后4 h(T_6)采集静脉血标本,记录血流动力学数值、心输出量和温度。生化酶学法检测血清中ALT、Lac的含量;ELISA法检测血清BHMT、IL-6、TNF-α的含量;各组于休克后4 h取右叶部分肝组织,HE染色观察肝脏病理组织学变化。结果与S组相比,HS组、Sev组血清TNF-α和Lac含量在T_2~T_6时点显著升高(P<0.05),血清ALT含量在T_4~T_6时点显著升高(P<0.05),血清中的IL-6和BHMT含量在T_3~T_6时点显著升高(P<0.05),病理学损伤明显。与HS组相比,Sev组血清TNF-α和Lac含量在T_2~T_6时点显著降低(P<0.05),血清ALT含量在T_4~T_6时点显著降低(P<0.05),血清IL-6和BHMT含量在T_3~T_6时点显著降低(P<0.05),病理学损伤减轻。结论七氟烷后处理可在一定程度上减轻失血性休克引起的巴马小型猪肝脏损伤,可能与其抑制应激和炎症反应有关。

Objective T1o investigate the effect of post-treatment with sevoflurane on liver function and BHMT1,IL-6,T1NF-α in Bama minipigs with hemorrhagic shock. Methods A total of 24 Bama minipigs were randomly divided into 3 groups： Sham group（ group S,n = 8）,hemorrhagic shock group（ group HS,n = 8） and sevoflurane post-treatment group（ group Sev）. T1he hemorrhagic shock model after anesthesia in group HS was established. In group Sev,Bama minipigs were given 2% sevoflurane for 30 min after establishing the model. Blood samples were taken at the following time points： before experiment（ T10）,and 0. 5 h（ T11） 1 h（ T12）,1. 5 h（ T13）,2 h（ T14）,3 h（ T15） and 4 h（ T16） after shock. T1he hemodynamic values,cardiac output value and temperature were recorded. Biochemicalenzymic method was used to determine the content of serum ALT1 and Lac; ELISA was used to determine the content of BHMT1,IL-6 and T1NF-α,some tissues were taken from the right liver 4 h after shock in all the groups,and the liver histopathological changes were analyzed by HE staining. Results Compared with group S,the serum T1NF-αand Lac content was significantly increased in group HS and Sev at T12 - T16（ P〈0. 05）; the serum ALT1 content was significantly increased at T14 - T16（ P〈0. 05）; the serum IL-6 and BHMT1 content was significantly increased at T13 - T16（ P〈0. 05）; there was obvious pathological damage. Compared with group HS,the content of T1NF-α and Lac in group Sev was significantly reduced at T12 - T16（ P〈0. 05）; the ALT1 was significantly reduced at T14 - T16（ P〈0. 05）; the IL-6 and BHMT1 was significantly reduced at T13 - T16（ P〈0. 05）. Conclusion T1o some extent,sevoflurane can reduce Bama minipigs＇ liver damage induced by hemorrhagic shock. T1he protective effect of sevoflurane is probably related to inhibition of the hemorrhagic shock-induced inflammatory or stress response.