CAJ | 학술논문

目的：观察血必净注射液对脓毒性休克大鼠器官微观结构的影响。方法选择清洁级雄性SD大鼠15只，按随机数字表法分为假手术组、模型组和血必净组，每组5只。采用盲肠结扎穿孔术（CLP）制备腹腔感染致脓毒性休克大鼠模型；假手术组仅行腹腔正中切开，探查腹腔，翻动盲肠后关腹。血必净组术后1h内经股静脉插管给予血必净注射液4 mL/kg，之后以生理盐水2 mL·kg-1·h-1持续输注至处死之前；假手术组和模型组术后给予等量生理盐水。所有大鼠经右侧颈动脉置管接压力装置连续监测血压变化，观察至12 h后处死大鼠留取心、肺、肝及肾脏标本，电镜下观察超微结构的改变。结果假手术组血压随时间延长轻微下降，但基本正常。模型组于术后9 h、血必净组约在术后10 h进入休克状态，平均动脉压（MAP）低于70 mmHg （1 mmHg＝0.133 kPa）；术后11 h，模型组和血必净组MAP均较假手术组明显降低（mmHg：58.7±7.0、58.7±8.3比91.0±8.2，均P＜0.01），术后12 h持续降低，但血必净组略高于同期模型组（mmHg：55.4±4.0比48.8±12.9， P＞0.05）。电镜下观察可见：假手术组心、肺、肝及肾各器官结构基本正常；模型组各器官均出现不同程度的结构损伤；而血必净组大鼠心脏和肺脏的损伤较模型组减轻，特别是细胞内线粒体改变明显，肾脏及肝脏的损伤较模型组无明显变化。结论血必净注射液对稳定脓毒性休克大鼠循环系统有一定的作用，并有可能减轻感染及休克对大鼠心脏和肺脏的损伤。
목적：관찰혈필정주사액대농독성휴극대서기관미관결구적영향。방법선택청길급웅성SD대서15지，안수궤수자표법분위가수술조、모형조화혈필정조，매조5지。채용맹장결찰천공술（CLP）제비복강감염치농독성휴극대서모형；가수술조부행복강정중절개，탐사복강，번동맹장후관복。혈필정조술후1h내경고정맥삽관급여혈필정주사액4 mL/kg，지후이생리염수2 mL·kg-1·h-1지속수주지처사지전；가수술조화모형조술후급여등량생리염수。소유대서경우측경동맥치관접압력장치련속감측혈압변화，관찰지12 h후처사대서류취심、폐、간급신장표본，전경하관찰초미결구적개변。결과가수술조혈압수시간연장경미하강，단기본정상。모형조우술후9 h、혈필정조약재술후10 h진입휴극상태，평균동맥압（MAP）저우70 mmHg （1 mmHg＝0.133 kPa）；술후11 h，모형조화혈필정조MAP균교가수술조명현강저（mmHg：58.7±7.0、58.7±8.3비91.0±8.2，균P＜0.01），술후12 h지속강저，단혈필정조략고우동기모형조（mmHg：55.4±4.0비48.8±12.9， P＞0.05）。전경하관찰가견：가수술조심、폐、간급신각기관결구기본정상；모형조각기관균출현불동정도적결구손상；이혈필정조대서심장화폐장적손상교모형조감경，특별시세포내선립체개변명현，신장급간장적손상교모형조무명현변화。결론혈필정주사액대은정농독성휴극대서순배계통유일정적작용，병유가능감경감염급휴극대대서심장화폐장적손상。
Objective To investigate the influences of Xuebijing injection on organs' ultra-microstructure in septic shock rats. Methods Fifteen male Sprague-Dawley (SD) rats of clean grade were selected. According to the method of random digits table, all of them were divided into three groups: sham operation group, model group and Xuebijing treated group, 5 rats being in each group. Cecal ligation and puncture (CLP) was adopted to reproduce abdominal cavity infection leading to sepsis model formation. While the rats in sham operation group just underwent abdominal median incision, abdominal exploration and closure of abdominal wall after flipping retrocecal region. In the Xuebijing treated group, within 1 hour after the operation, Xuebijing injection (4 mL/kg) was transfused through the catheter inserted in the femoral vein, and then normal saline (2 mL·kg-1·h-1) was continuously transfused until the rat being sacrificed. In the sham operation group and model group, equal volume of normal saline was given after operation. The blood pressure of all the rats was monitored continuously by a pressure device connected with a catheter inserted in the right carotid artery. The rats were observed for 12 hours, afterwards they were sacrificed, the samples of heart, lung, kidney and liver were taken, and their ultrastructural changes were observed under an electron microscope. Results The blood pressure of sham operation group was decreased a little with time extension, but within normal limits. The mean arterial pressure (MAP) of model group and Xuebijing treated group developed into a state of sepsis shock at 9 hours and 10 hours after operation respectively, and MAP were lower than 70 mmHg (1 mmHg=0.133 kPa). The MAP levels of model and Xuebijing groups at 11 hours after operation were lower significantly than those of sham operation group (mmHg:58.7±7.0, 58.7±8.3 vs. 91.0±8.2, both P<0.01), and they were persistently decreased at 12 hours after operation;the MAP in Xuebijing group was a little higher than that of model group at the same period (mmHg:55.4±4.0 vs. 48.8±12.9, P>0.05). The results of the observation with electron microscope:the structures of heart, lung, liver and kidney in sham operation group were basically normal;all the organs of model group appeared different degrees of structural damage. Compared with model group, the injury of heart and lung in Xuebijing treated group was milder, especially, the changes of cellular mitochondria were obvious;however, there was no significant difference in injury of kidney and liver between the model and Xuebijing treated groups. Conclusion Xuebijing injection can play a certain role in stabilizing the circulatory system in rats with septic shock, and can possibly ameliorate the heart and lung damage caused by infection and shock.