中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2015年
2期
106-109
,共4页
多器官功能障碍综合征%大承气汤%平滑肌%线粒体%胃肠动力
多器官功能障礙綜閤徵%大承氣湯%平滑肌%線粒體%胃腸動力
다기관공능장애종합정%대승기탕%평활기%선립체%위장동력
Multiple organ dysfunction syndrome%Dachengqi decoction%Smooth muscle%Mitochondrion%Gastrointestinal motility
目的：通过检测大鼠小肠平滑肌线粒体凋亡信号通路Bcl-2、 Bax以及核转录因子-κB（NF-κB）的蛋白表达，探讨大承气汤促进多器官功能障碍综合征（MODS）胃肠动力恢复的机制。方法健康成年Wistar大鼠100只，按随机数字表法分为对照组（20只）、模型组（40只）和大承气汤组（40只）。经腹腔注射1 mL大肠杆菌混悬液（8×108 cfu/mL）制备细菌性腹膜炎致MODS大鼠模型，对照组则腹腔注射1 mL生理盐水；大承气汤组于制模前2 d灌胃大承气汤，每次10 mL/kg，每日2次。各组于制模24 h后脱颈活杀大鼠取上段小肠，采用免疫组化法检测小肠平滑肌Bcl-2、 Bax和NF-κB的蛋白表达。结果对照组可见小肠平滑肌有大量分布均匀的Bcl-2蛋白表达及少量分布均匀的Bax、 NF-κB蛋白表达。与对照组比较，模型组小肠平滑肌Bcl-2蛋白表达分布稀疏，呈散块状区域表达，Bcl-2蛋白表达明显减少（积分A值：7115.3±1797.2比22085.5±4892.2，P＜0.05），以环层肌中尤为明显；Bax、NF-κB蛋白分布密集，表达均明显升高〔Bax（积分A值）：33802.6±5778.0比7984.4±1804.5，NF-κB（积分A值）：2465.9±664.8比1572.6±256.0，均P＜0.05〕，尤以环行肌中升高明显。与模型组比较，大承气汤组大鼠小肠平滑肌中Bcl-2蛋白表达明显升高（积分A值：12458.6±2491.1比7115.3±1797.2，P＜0.05），Bax、 NF-κB蛋白表达明显减少〔Bax（积分A值）：12529.2±2018.5比33802.6±5778.0，NF-κB（积分A值）：1843.1±373.6比2465.9±664.8，均P＜0.05〕，以环行肌中尤为显著。结论大承气汤可能通过增加线粒体外膜Bcl-2表达，抑制Bax向线粒体膜移位，从而减轻MODS大鼠小肠平滑肌线粒体的损伤，促进胃肠动力的恢复。
目的：通過檢測大鼠小腸平滑肌線粒體凋亡信號通路Bcl-2、 Bax以及覈轉錄因子-κB（NF-κB）的蛋白錶達，探討大承氣湯促進多器官功能障礙綜閤徵（MODS）胃腸動力恢複的機製。方法健康成年Wistar大鼠100隻，按隨機數字錶法分為對照組（20隻）、模型組（40隻）和大承氣湯組（40隻）。經腹腔註射1 mL大腸桿菌混懸液（8×108 cfu/mL）製備細菌性腹膜炎緻MODS大鼠模型，對照組則腹腔註射1 mL生理鹽水；大承氣湯組于製模前2 d灌胃大承氣湯，每次10 mL/kg，每日2次。各組于製模24 h後脫頸活殺大鼠取上段小腸，採用免疫組化法檢測小腸平滑肌Bcl-2、 Bax和NF-κB的蛋白錶達。結果對照組可見小腸平滑肌有大量分佈均勻的Bcl-2蛋白錶達及少量分佈均勻的Bax、 NF-κB蛋白錶達。與對照組比較，模型組小腸平滑肌Bcl-2蛋白錶達分佈稀疏，呈散塊狀區域錶達，Bcl-2蛋白錶達明顯減少（積分A值：7115.3±1797.2比22085.5±4892.2，P＜0.05），以環層肌中尤為明顯；Bax、NF-κB蛋白分佈密集，錶達均明顯升高〔Bax（積分A值）：33802.6±5778.0比7984.4±1804.5，NF-κB（積分A值）：2465.9±664.8比1572.6±256.0，均P＜0.05〕，尤以環行肌中升高明顯。與模型組比較，大承氣湯組大鼠小腸平滑肌中Bcl-2蛋白錶達明顯升高（積分A值：12458.6±2491.1比7115.3±1797.2，P＜0.05），Bax、 NF-κB蛋白錶達明顯減少〔Bax（積分A值）：12529.2±2018.5比33802.6±5778.0，NF-κB（積分A值）：1843.1±373.6比2465.9±664.8，均P＜0.05〕，以環行肌中尤為顯著。結論大承氣湯可能通過增加線粒體外膜Bcl-2錶達，抑製Bax嚮線粒體膜移位，從而減輕MODS大鼠小腸平滑肌線粒體的損傷，促進胃腸動力的恢複。
목적：통과검측대서소장평활기선립체조망신호통로Bcl-2、 Bax이급핵전록인자-κB（NF-κB）적단백표체，탐토대승기탕촉진다기관공능장애종합정（MODS）위장동력회복적궤제。방법건강성년Wistar대서100지，안수궤수자표법분위대조조（20지）、모형조（40지）화대승기탕조（40지）。경복강주사1 mL대장간균혼현액（8×108 cfu/mL）제비세균성복막염치MODS대서모형，대조조칙복강주사1 mL생리염수；대승기탕조우제모전2 d관위대승기탕，매차10 mL/kg，매일2차。각조우제모24 h후탈경활살대서취상단소장，채용면역조화법검측소장평활기Bcl-2、 Bax화NF-κB적단백표체。결과대조조가견소장평활기유대량분포균균적Bcl-2단백표체급소량분포균균적Bax、 NF-κB단백표체。여대조조비교，모형조소장평활기Bcl-2단백표체분포희소，정산괴상구역표체，Bcl-2단백표체명현감소（적분A치：7115.3±1797.2비22085.5±4892.2，P＜0.05），이배층기중우위명현；Bax、NF-κB단백분포밀집，표체균명현승고〔Bax（적분A치）：33802.6±5778.0비7984.4±1804.5，NF-κB（적분A치）：2465.9±664.8비1572.6±256.0，균P＜0.05〕，우이배행기중승고명현。여모형조비교，대승기탕조대서소장평활기중Bcl-2단백표체명현승고（적분A치：12458.6±2491.1비7115.3±1797.2，P＜0.05），Bax、 NF-κB단백표체명현감소〔Bax（적분A치）：12529.2±2018.5비33802.6±5778.0，NF-κB（적분A치）：1843.1±373.6비2465.9±664.8，균P＜0.05〕，이배행기중우위현저。결론대승기탕가능통과증가선립체외막Bcl-2표체，억제Bax향선립체막이위，종이감경MODS대서소장평활기선립체적손상，촉진위장동력적회복。
ObjectiveTo discuss the mechanism of promotion of gastrointestinal motility during multiple organ dysfunction syndrome ( MODS ) by Dachengqi decoction, by examining the expression of Bcl-2, Bax of mitochondrial pathway, and nuclear factor-κB (NF-κB) in smooth muscle of the small intestinal in rats.Methods According to the random number table, 100 healthy adult Wistar rats were divided into three groups: control group with 20 rats, model group with 40 rats, and Dachengqi decoction group with 40 rats. Rat model of MODS was reproduced by bacterial peritonitis induced by an injection of 1 mLEscherichia coli suspension (8×108 cfu/mL) into peritoneal cavity. The rats in control group were given 1 mL normal saline intraperitoneally. The rats in Dachengqi decoction group were given 10 mL/kg Dachengqi decoction by gavage, twice a day, before inoculation of the bacterial suspension. Twenty-four hours after modelling, rats in all groups were sacrificed by cervical vertebra luxation, and the upper small intestine was harvested to detect the protein expressions of Bcl-2, Bax, and NF-κB in smooth muscle tissue using immunohistochemical staining.Results In the control group, a large amount of Bcl-2 protein was expressed and it was distributed uniformly in small intestinal smooth muscle. On the other hand, a small amount of Bax and NF-κB protein was expressed, and they were also distributed uniformly. Compared with the control group, Bcl-2 protein was distributed only sparsely, and it was scattered in intestinal smooth muscle in blocks in the model group. The expression of Bcl-2 protein was obviously down-regulated [integral optical density (A) value: 7 115.3±1 797.2 vs. 22 085.5±4 892.2, P< 0.05], and this phenomenon was more prominent in circular muscle layer. Bax and NF-κB were densely distributed, and their expressions were upgraded obviously [Bax (A value): 33 802.6±5 778.0 vs. 7 984.4±1 804.5, NF-κB (A value): 2 465.9±664.8 vs. 1 572.6±256.0, bothP< 0.05]. This phenomenon was more outstanding in circular muscle layer. Compared with that of the model group, the expression of Bcl-2 protein was stronger obviously in intestinal smooth muscle in Dachengqi decoction group (A value: 12 458.6±2 491.1 vs. 7 115.3±1 797.2,P<0.05). The expressions of Bax and NF-κB were down-regulated obviously [Bax (A value): 12 529.2±2 018.5 vs. 33 802.6±5 778.0, NF-κB (A value): 1 843.1±373.6 vs. 2 465.9±664.8, bothP< 0.05], and the change was more obvious in circular muscle layer.Conclusions Dachengqi decoction may promote recovery of gastrointestinal motility through an increase of Bcl-2 expression in nuclear membrane, thus preventing translocation of Bax to mitochondrion, thereby reduces mitochondrial damage in MODS.
