中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2014年
3期
186-189
,共4页
张红金%刘娇%吴相伟%崔云亮%陈德昌
張紅金%劉嬌%吳相偉%崔雲亮%陳德昌
장홍금%류교%오상위%최운량%진덕창
大黄%脓毒症%细胞免疫%糖皮质激素受体
大黃%膿毒癥%細胞免疫%糖皮質激素受體
대황%농독증%세포면역%당피질격소수체
Rhubarb%Sepsis%Cell immunity%Glucocorticoids receptor
目的：探讨大黄对烫伤后脓毒症大鼠糖皮质激素受体（GR）和外周血淋巴细胞的影响。方法将66只健康雄性SD大鼠按随机数字表法分为假手术对照组（18只）、脓毒症模型组（24只）和大黄治疗组（24只）；每组再分为12、24和72 h 3个亚组。用沸水造成大鼠背部体表面积30%的深Ⅲ度烫伤，12 h后腹腔注射5 mg/kg的内毒素复制脓毒症模型。大黄治疗组于脓毒症制模成功后即刻用50 mg/kg的大黄溶于1 mL的生理盐水经胃管灌入；假手术对照组和脓毒症模型组以等量生理盐水代替大黄灌胃。检测各组大鼠外周血白细胞GR结合容量和肝细胞GR结合活性的变化；采流式细胞仪检测各组大鼠外周血CD4+、CD8+细胞及CD4+/CD8+比值。结果脓毒症模型组大鼠外周血白细胞GR结合容量和肝细胞GR结合活性均较假手术对照组明显降低，且随时间延长呈进一步下降趋势；大黄干预后随时间延长上述指标呈上升趋势，且均明显高于同期脓毒症模型组〔12、24、72 h白细胞GR结合容量（位点/细胞）：1515.38±300.44、1859.63±258.26、1890.50±307.88比1122.63±225.39、1008.88±150.41、724.38±91.19，肝细胞GR结合活性（fmol/mg）：210.19±26.26、258.01±20.98、283.38±38.21比153.11±30.07、129.83±26.89、94.08±14.30，均P＜0.01〕。脓毒症模型组12 h、24 h CD4+、CD8+均较假手术对照组同期有不同程度下降，24 h与假手术对照组同期比较差异有统计学意义（P＜0.01和P＜0.05）；各时相间点CD4+/CD8+比值亦有明显下降，其中24 h、72 h与假手术对照组同期比较差异均有统计学意义（均P＜0.01）。大黄治疗组各时间点CD4+和CD4+/CD8+比值均有不同程度升高，其中24 h、72 h CD4+/CD8+比值与脓毒症模型组同期比较差异有统计学意义（1.58±0.69、1.56±0.49比1.02±0.41、1.01±1.68，均P＜0.01）。结论大黄能调节脓毒症大鼠外周血白细胞GR结合容量和肝细胞GR结合活性，通过影响外周血淋巴细胞数量，改善脓毒症免疫功能紊乱。
目的：探討大黃對燙傷後膿毒癥大鼠糖皮質激素受體（GR）和外週血淋巴細胞的影響。方法將66隻健康雄性SD大鼠按隨機數字錶法分為假手術對照組（18隻）、膿毒癥模型組（24隻）和大黃治療組（24隻）；每組再分為12、24和72 h 3箇亞組。用沸水造成大鼠揹部體錶麵積30%的深Ⅲ度燙傷，12 h後腹腔註射5 mg/kg的內毒素複製膿毒癥模型。大黃治療組于膿毒癥製模成功後即刻用50 mg/kg的大黃溶于1 mL的生理鹽水經胃管灌入；假手術對照組和膿毒癥模型組以等量生理鹽水代替大黃灌胃。檢測各組大鼠外週血白細胞GR結閤容量和肝細胞GR結閤活性的變化；採流式細胞儀檢測各組大鼠外週血CD4+、CD8+細胞及CD4+/CD8+比值。結果膿毒癥模型組大鼠外週血白細胞GR結閤容量和肝細胞GR結閤活性均較假手術對照組明顯降低，且隨時間延長呈進一步下降趨勢；大黃榦預後隨時間延長上述指標呈上升趨勢，且均明顯高于同期膿毒癥模型組〔12、24、72 h白細胞GR結閤容量（位點/細胞）：1515.38±300.44、1859.63±258.26、1890.50±307.88比1122.63±225.39、1008.88±150.41、724.38±91.19，肝細胞GR結閤活性（fmol/mg）：210.19±26.26、258.01±20.98、283.38±38.21比153.11±30.07、129.83±26.89、94.08±14.30，均P＜0.01〕。膿毒癥模型組12 h、24 h CD4+、CD8+均較假手術對照組同期有不同程度下降，24 h與假手術對照組同期比較差異有統計學意義（P＜0.01和P＜0.05）；各時相間點CD4+/CD8+比值亦有明顯下降，其中24 h、72 h與假手術對照組同期比較差異均有統計學意義（均P＜0.01）。大黃治療組各時間點CD4+和CD4+/CD8+比值均有不同程度升高，其中24 h、72 h CD4+/CD8+比值與膿毒癥模型組同期比較差異有統計學意義（1.58±0.69、1.56±0.49比1.02±0.41、1.01±1.68，均P＜0.01）。結論大黃能調節膿毒癥大鼠外週血白細胞GR結閤容量和肝細胞GR結閤活性，通過影響外週血淋巴細胞數量，改善膿毒癥免疫功能紊亂。
목적：탐토대황대탕상후농독증대서당피질격소수체（GR）화외주혈림파세포적영향。방법장66지건강웅성SD대서안수궤수자표법분위가수술대조조（18지）、농독증모형조（24지）화대황치료조（24지）；매조재분위12、24화72 h 3개아조。용비수조성대서배부체표면적30%적심Ⅲ도탕상，12 h후복강주사5 mg/kg적내독소복제농독증모형。대황치료조우농독증제모성공후즉각용50 mg/kg적대황용우1 mL적생리염수경위관관입；가수술대조조화농독증모형조이등량생리염수대체대황관위。검측각조대서외주혈백세포GR결합용량화간세포GR결합활성적변화；채류식세포의검측각조대서외주혈CD4+、CD8+세포급CD4+/CD8+비치。결과농독증모형조대서외주혈백세포GR결합용량화간세포GR결합활성균교가수술대조조명현강저，차수시간연장정진일보하강추세；대황간예후수시간연장상술지표정상승추세，차균명현고우동기농독증모형조〔12、24、72 h백세포GR결합용량（위점/세포）：1515.38±300.44、1859.63±258.26、1890.50±307.88비1122.63±225.39、1008.88±150.41、724.38±91.19，간세포GR결합활성（fmol/mg）：210.19±26.26、258.01±20.98、283.38±38.21비153.11±30.07、129.83±26.89、94.08±14.30，균P＜0.01〕。농독증모형조12 h、24 h CD4+、CD8+균교가수술대조조동기유불동정도하강，24 h여가수술대조조동기비교차이유통계학의의（P＜0.01화P＜0.05）；각시상간점CD4+/CD8+비치역유명현하강，기중24 h、72 h여가수술대조조동기비교차이균유통계학의의（균P＜0.01）。대황치료조각시간점CD4+화CD4+/CD8+비치균유불동정도승고，기중24 h、72 h CD4+/CD8+비치여농독증모형조동기비교차이유통계학의의（1.58±0.69、1.56±0.49비1.02±0.41、1.01±1.68，균P＜0.01）。결론대황능조절농독증대서외주혈백세포GR결합용량화간세포GR결합활성，통과영향외주혈림파세포수량，개선농독증면역공능문란。
Objective To investigate the effects of rhubarb on the expression of glucocorticoids receptor (GR)and peripheral blood lymphocytes in burning-induced septic rats. Methods Sixty-six male healthy Sprague-Dawley(SD)rats were randomly divided into sham operated control group(n=18),sepsis model group(n=24) and rhubarb treatment group(n=24),each group was further randomly divided into 12,24 and 72 hours subgroups according to different time points. The model of scald sepsis was replicated by scald injury induced by boiling water at the rat back accounting for 30% total body surface area(Ⅲ grade of scald),and administration of endotoxin (5 mg/kg)into the peritoneal cavity 12 hours after scald injury. After the successful establishment of septic models, the rats in the rhubarb treatment group were immediately infused with 50 mg/kg rhubarb powder dissolved in 1 mL saline through a gastric tube,while the rats in sham operated control group and sepsis model group received saline by the same way as a substitute for rhubarb. The the binding capacity of GR of peripheral blood leucocyte and binding activity of GR of hepatocyte were analyzed by radiation ligands binding assay. The CD4+,CD8+as well as CD4+/CD8+ ratio in peripheral blood lymphocytes were detected by flow cytometer. Results The binding capacity of GR of peripheral blood leucocyte and binding activity of GR of hepatocyte were significantly decreased in a time-dependent manner in sepsis model group compared to those of the sham operated control group,while in the rhubarb treatment group they were increased in a time-dependent manner after interference of rhubarb, and they were higher than those in the model group at the same time points〔leukocyte GR binding capacity (locus/cell)at 12,24,72 hours :1 515.38±300.44,1 859.63±258.26,1 890.50±307.88 vs. 1 122.63±225.39, 1 008.88±150.41,724.38±91.19;hepatocyte GR binding capacity(fmol/mg):210.19±26.26,258.01±20.98, 283.38±38.21 vs. 153.11±30.07, 129.83±26.89, 94.08±14.30, all P<0.01〕. Compared with the sham operated control group,the CD4+ and CD8+ were decreased in various degrees at 12 hours and 24 hours in the septic group, at 24 hours the differences being statistically significant (P<0.01 and P<0.05). CD4+/CD8+ratios were decreased significantly at all time points,the differences were statistically significant at 24 hours and 72 hours(both P<0.01). The CD4+ T cell and CD4+/CD8+ ratio at all the time points were increased at various degrees in the rhubarb treatment group,and the differences from those in the sepsis model group at 24 hours and 72 hours were statistically significant (1.58±0.69, 1.56±0.49 vs. 1.02±0.41, 1.01±1.68, both P<0.01). Conclusion Rhubarb can modulate the binding capacity of GR of peripheral blood leucocyte and the binding activity of GR of hepatocyte,and via its influence on the number of peripheral leucocytes,the immune dysfunction in the sepsis processes is improved.
