甘氨酸对出血性休克大白鼠生存率的影响

The effect of glycine on survival after hemorrhagic shock in the rats

目的 研究甘氨酸对出血性休克大白鼠生存率的影响并探讨机制。方法 大白鼠经动脉放血 ,造成出血性休克 ,随后用自体血和生理盐水回输进行复苏。复苏前大白鼠分成 3组 :假休克组 ,休克组和甘氨酸治疗组。结果 (1)复苏后 72h ,休克组与甘氨酸治疗组的生存率分别为 2 0 0 %和 77 8% ,差异有显著意义 (P <0 0 5 )。 (2 )复苏后 18h器官取材显示 :休克组大白鼠的肺、肾等组织出现水肿、变性、炎性细胞浸润等 ,甘氨酸治疗组上述的病理改变明显减轻。 (3)复苏后 18h ,肌酸磷酸激酶、肌酐、谷丙转氨酶、谷草转氨酶、碱性磷酸酶检测 ,休克组明显升高 ,而甘氨酸治疗组只有轻度增高 ,差异有非常显著性意义 (P <0 0 1)。 (4)复苏后 2h ,肝脏分离培养的枯否细胞用内毒素刺激后 ,休克组细胞内Ca2 + 浓度和TNF α产量明显高于甘氨酸治疗组 ,差异有非常显著性意义 (P <0 0 1)。结论 甘氨酸通过抑制枯否细胞内Ca2 + 浓度升高和抑制TNF α的过度产生 ,降低机体全身炎症反应程度 ,减轻出血性休克大白鼠脏器的损伤和降低病死率。

Objective To investigate the effect of glycine on survival after hemorrhagic shock in the rats and elucidate the underlying mechanisms. Methods Wistar rats were bled to establish the shock model and subsequently resuscitated with shed blood and normal saline. Just prior to resuscitation,the rats were divided into three groups: sham group,shock group and shock+glycine group. Results (1) 72 h after resuscitation,the survival rate of shock group decreased to 20%,while the survival rate of shock+glycine group was 77.8%,the difference was significant ( P <0.05). (2) 18 h after resuscitation,pathologic alterations of organs showed, pulmonary edema,leukocyte infiltration in interstitial tissue and cellular degeneration in shock group. Glycine reduced these pathological alterations significantly. (3) 18 h after resuscitation,creatine phosphokinase,transaminases and creatinin were elevated significantly in shock group,while these were elevated slightly in shock+glycine group,the differences were significant ( P <0.01). (4) Increases in intracellular calcium and production of TNF-α by isolated Kupffer cells stimulated by endotoxin were elevated significantly by hemorrhagic shock,which were totally prevented by glycine ( P <0.01). Conclusion Glycine reduces organ injury and mortality caused by hemorrhagic shock by preventing increase of intracellular calcium and production of TNF-α of Kupffer cells and blocking systemic inflammation responses.