中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
3期
256-259
,共4页
吕艳霞%张丽峰%李海英%王力利%刘瑶%王秋筠
呂豔霞%張麗峰%李海英%王力利%劉瑤%王鞦筠
려염하%장려봉%리해영%왕력리%류요%왕추균
阿魏酸钠%创伤%失血性休克%复苏损伤%胃黏膜
阿魏痠鈉%創傷%失血性休剋%複囌損傷%胃黏膜
아위산납%창상%실혈성휴극%복소손상%위점막
Sodium ferulate%Trauma%Hemorrhagic shock%Resuscitative injury%Gastric mucosa
目的 探讨阿魏酸钠(sodium ferulate,SF)对创伤失血性休克复苏胃黏膜损伤(traumatic hemorrhagic shock resuscitation-gastric mucosal injury,THSR-GMI)的作用及机制.方法 本实验于河北医科大学生理实验室完成.家兔100只,按随机数字表法分为4组:对照组(A组)、模型组(B组)、复苏前(C组)及复苏后(D组)应用SF组,每组25只.除A组外均以股骨粉碎骨折并放血法复制家兔THSR-GMI模型.复苏前20 min C组及复苏30 min时D组由耳缘静脉缓慢静注SF 30 mg/kg,其余各组均给予等容量生理盐水替代.复苏90 min取胃黏膜标本,按Guth方法计算胃黏膜损伤指数(DI),电子显微镜下观察胃黏膜壁细胞超微结构改变,用放射免疫法测定胃黏膜组织血栓素B2( TXB2)、6-酮-前列环素F1α(6-Keto-PGF1α)含量,计算TXB2/6-Keto-PGF1α比值.组间比较采用单因素方差分析(LSD-t检验),以P＜0.05为差异具有统计学意义.结果 ①电镜下:A组壁细胞分泌小管紧闭,呈明显静息状态；B组分泌小管增多、管腔明显扩张；C组较B组分泌小管减少、扩张不明显；D组分泌小管情况介于B、C两组之间.②与A组比,其余3组的DI值[(81.5±13.6)、 (61.3±18.2)、 (70.5±17.2)vs.(4.2±2.7)]、TXB2含量[ (4.95±0.51)、(3.75±0.64)、(4.39±0.69) vs. (2.76±0.44)]及TXB2/6-Keto-PGF1α比值[ (0.064±0.002)、(0.037±0.005)、(0.049 ±0.002) vs.(0.027 ±0.002)]均升高(P＜0.01),而6-Keto-PGF1α[(77.9±8.9)、(96.4±11.2)、(89.2±11.4) vs.(109.3±7.6)]降低(P＜0.05或P＜0.01).与B组比,C、D两组DI值[(61.3±18.2)、 (70.5±17.2) vs.(81.5±13.6)]、TXB2含量[(3.75 ±0.64)、(4.39±0.69) vs.(4.95±0.51)]及TXB2/6-Keto-PGF1α比值[ (0.037 ±0.005)、(0.049±0.002) vs.(0.064±0.002)]均降低(P＜0.05或P＜0.01),而6-Keto-PGF1α含量[(96.4±11.2)、 (89.2±11.4) vs.(77.9±8.9)]升高(P＜0.05或P＜0.01).与C组比,D组DI值[(70.5±17.2) vs.(61.3±18.2)]、TXB2含量[(4.39±0.69) vs.(3.75±0.64)]及TXB2/6-Keto-PGF1α比值[(0.049±0.002) vs.(0.037±0.005)]均升高(P＜0.05或P＜0.01),而6-Keto-PGF1α含量[(89.2±11.4) vs.(96.4±11.2)]降低(P＜0.05).结论 SF可减轻家兔HTSR-GM1,且复苏前应用效果较佳,其机制可能与SF防治或改善TXA2/PGI2平衡紊乱、抑制壁细胞的分泌功能有关.
目的 探討阿魏痠鈉(sodium ferulate,SF)對創傷失血性休剋複囌胃黏膜損傷(traumatic hemorrhagic shock resuscitation-gastric mucosal injury,THSR-GMI)的作用及機製.方法 本實驗于河北醫科大學生理實驗室完成.傢兔100隻,按隨機數字錶法分為4組:對照組(A組)、模型組(B組)、複囌前(C組)及複囌後(D組)應用SF組,每組25隻.除A組外均以股骨粉碎骨摺併放血法複製傢兔THSR-GMI模型.複囌前20 min C組及複囌30 min時D組由耳緣靜脈緩慢靜註SF 30 mg/kg,其餘各組均給予等容量生理鹽水替代.複囌90 min取胃黏膜標本,按Guth方法計算胃黏膜損傷指數(DI),電子顯微鏡下觀察胃黏膜壁細胞超微結構改變,用放射免疫法測定胃黏膜組織血栓素B2( TXB2)、6-酮-前列環素F1α(6-Keto-PGF1α)含量,計算TXB2/6-Keto-PGF1α比值.組間比較採用單因素方差分析(LSD-t檢驗),以P＜0.05為差異具有統計學意義.結果 ①電鏡下:A組壁細胞分泌小管緊閉,呈明顯靜息狀態；B組分泌小管增多、管腔明顯擴張；C組較B組分泌小管減少、擴張不明顯；D組分泌小管情況介于B、C兩組之間.②與A組比,其餘3組的DI值[(81.5±13.6)、 (61.3±18.2)、 (70.5±17.2)vs.(4.2±2.7)]、TXB2含量[ (4.95±0.51)、(3.75±0.64)、(4.39±0.69) vs. (2.76±0.44)]及TXB2/6-Keto-PGF1α比值[ (0.064±0.002)、(0.037±0.005)、(0.049 ±0.002) vs.(0.027 ±0.002)]均升高(P＜0.01),而6-Keto-PGF1α[(77.9±8.9)、(96.4±11.2)、(89.2±11.4) vs.(109.3±7.6)]降低(P＜0.05或P＜0.01).與B組比,C、D兩組DI值[(61.3±18.2)、 (70.5±17.2) vs.(81.5±13.6)]、TXB2含量[(3.75 ±0.64)、(4.39±0.69) vs.(4.95±0.51)]及TXB2/6-Keto-PGF1α比值[ (0.037 ±0.005)、(0.049±0.002) vs.(0.064±0.002)]均降低(P＜0.05或P＜0.01),而6-Keto-PGF1α含量[(96.4±11.2)、 (89.2±11.4) vs.(77.9±8.9)]升高(P＜0.05或P＜0.01).與C組比,D組DI值[(70.5±17.2) vs.(61.3±18.2)]、TXB2含量[(4.39±0.69) vs.(3.75±0.64)]及TXB2/6-Keto-PGF1α比值[(0.049±0.002) vs.(0.037±0.005)]均升高(P＜0.05或P＜0.01),而6-Keto-PGF1α含量[(89.2±11.4) vs.(96.4±11.2)]降低(P＜0.05).結論 SF可減輕傢兔HTSR-GM1,且複囌前應用效果較佳,其機製可能與SF防治或改善TXA2/PGI2平衡紊亂、抑製壁細胞的分泌功能有關.
목적 탐토아위산납(sodium ferulate,SF)대창상실혈성휴극복소위점막손상(traumatic hemorrhagic shock resuscitation-gastric mucosal injury,THSR-GMI)적작용급궤제.방법 본실험우하북의과대학생리실험실완성.가토100지,안수궤수자표법분위4조:대조조(A조)、모형조(B조)、복소전(C조)급복소후(D조)응용SF조,매조25지.제A조외균이고골분쇄골절병방혈법복제가토THSR-GMI모형.복소전20 min C조급복소30 min시D조유이연정맥완만정주SF 30 mg/kg,기여각조균급여등용량생리염수체대.복소90 min취위점막표본,안Guth방법계산위점막손상지수(DI),전자현미경하관찰위점막벽세포초미결구개변,용방사면역법측정위점막조직혈전소B2( TXB2)、6-동-전렬배소F1α(6-Keto-PGF1α)함량,계산TXB2/6-Keto-PGF1α비치.조간비교채용단인소방차분석(LSD-t검험),이P＜0.05위차이구유통계학의의.결과 ①전경하:A조벽세포분비소관긴폐,정명현정식상태；B조분비소관증다、관강명현확장；C조교B조분비소관감소、확장불명현；D조분비소관정황개우B、C량조지간.②여A조비,기여3조적DI치[(81.5±13.6)、 (61.3±18.2)、 (70.5±17.2)vs.(4.2±2.7)]、TXB2함량[ (4.95±0.51)、(3.75±0.64)、(4.39±0.69) vs. (2.76±0.44)]급TXB2/6-Keto-PGF1α비치[ (0.064±0.002)、(0.037±0.005)、(0.049 ±0.002) vs.(0.027 ±0.002)]균승고(P＜0.01),이6-Keto-PGF1α[(77.9±8.9)、(96.4±11.2)、(89.2±11.4) vs.(109.3±7.6)]강저(P＜0.05혹P＜0.01).여B조비,C、D량조DI치[(61.3±18.2)、 (70.5±17.2) vs.(81.5±13.6)]、TXB2함량[(3.75 ±0.64)、(4.39±0.69) vs.(4.95±0.51)]급TXB2/6-Keto-PGF1α비치[ (0.037 ±0.005)、(0.049±0.002) vs.(0.064±0.002)]균강저(P＜0.05혹P＜0.01),이6-Keto-PGF1α함량[(96.4±11.2)、 (89.2±11.4) vs.(77.9±8.9)]승고(P＜0.05혹P＜0.01).여C조비,D조DI치[(70.5±17.2) vs.(61.3±18.2)]、TXB2함량[(4.39±0.69) vs.(3.75±0.64)]급TXB2/6-Keto-PGF1α비치[(0.049±0.002) vs.(0.037±0.005)]균승고(P＜0.05혹P＜0.01),이6-Keto-PGF1α함량[(89.2±11.4) vs.(96.4±11.2)]강저(P＜0.05).결론 SF가감경가토HTSR-GM1,차복소전응용효과교가,기궤제가능여SF방치혹개선TXA2/PGI2평형문란、억제벽세포적분비공능유관.
Objective To investigate the effect and mechanism of sodium ferulate (SF) on injury of gastric mucosa after traumatic hemorrhage shock resuscitation in rabbits.Methods One hundred healthy rabbits were randomly ( random number) divided into 4 groups ( n =25 in each group):control group ( A),model group ( B),pre-resuscitation SF group (C) and post-resuscitation SF group (D).The gastric mucosa injury model was established by using a method of comminuted fracture of femur and blood depletion.SF 30 mg/kg was injected into vein of rabbits' ear 20 min before resuscitation in group C and 30 min after resuscitation in group D,while rabbits of remaining groups received equal volume of normal saline instead.The gastric mucosa was obtained 90 min after resuscitation.The damage index (DI) of gastric mucosa was observed with method of Guth and the ultra-structure of parietal cell of stomach was observed under electronic microscope and the contents of TXB2 and 6-Keto-PGF1α in gastric tissue homogenate were determined with radio-immunity methods,and the ratios of TXB2/6-Keto-PGF1α were calculated.Data were analyzed by ANOVA ( LSD-t test ),and P ＜ 0.05 was considered as statistical significance. Results Under the electronic microscope,the secreting tubules were observed to be closed tightly in the parietal cells of stomach in the group A,showing a static status.However,in the group B,the number of normal secreting tubules was increased and the lumens were enlarged obviously.Compared with the group B,the number of normal secreting tubules was decreased and the enlargement of secreting tubules was not obvious in group C.The degree of changes in secreting tubules in group D was that between group C and group B.Compared with group A,the DI,the content of TXB2 and ratio of TXB2 to 6-Keto-PGF1α in other three groups were higher [DI: (81.5+13.6), (61.3+18.2), (70.5+17.2) vs.(4.2+2.7); the contents of TXB2:(4.95 +0.51),(3.75+0.64),(4.39±0.69) vs.(2.76±0.44); and the ratios of TXB2 to 6-KetoPGF1α:(0.064±0.002),(0.037±0.005), (0.049±0.002) vs.(0.027±0.002)] (P＜0.01),but the contents of 6-Keto-PGF1α in other 3 groups were lower [ (77.9±8.9),(96.4±11.2),(89.2+11.4) vs. (109.3±7.6)] (P＜0.05orP＜0.01).Compared with group B,theDI [ (61.3±18.2),(70.5±17.2) vs.(81.5±13.6)] and the contents of TXB2 [ (3.75±0.64), (4.39±0.69) vs.(4.95±0.51)] and the ratios ofTXB2 to6-Keto-PGF1α [ (0.037±0.005), (0.049±0.002) vs.(0.064 ±0.002)] in groups C and D were lower (P ＜ 0.05 or P ＜ 0.01 ),but the contents of 6-KetoPGF1α in groups C and D [ (96.4 ± 11.2),( 89.2 ± 11.4) vs.(77.9 ± 8.9) ] were higher ( P ＜ 0.05 or P ＜ 0.01 ).Compared with group C,the DI [ ( 70.5 ± 17.2) vs.61.3 ± 18.2) ] and the contents of TXB2 [ (4.39 ± 0.69) vs.(3.75 ± 0.64) ] and the ratios of TXB2 to 6-Keto-PGF1α [ (0.049 ± 0.002 ) vs.(0.037 +0.005) ] in group D were higher ( P ＜ 0.05 or P ＜ 0.01 ),but the content of 6-Keto-PGF1α in group D [ ( 89.2 ± 11.4 ) vs.(96.4 ± 11.2) ] was lower ( P ＜ 0.05 ).Conclusions SF can attenuate the injury of gastric mucosa after traumatic hemorrhage shock resuscitation in rabbits,and its therapeutic effects is better when it is administered before resuscitation than those as it is administered after resuscitation.The possible mechanism is associated with the effects of improving balance between TXB2 and 6-Keto-PGF1α and inhibiting the secreting function of parietal cell of stomach.
