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目的研究内毒素亲和吸附剂(EAA)对创伤失血性休克大鼠肠损害及炎症因子水平的影响。方法选取SD大鼠,按照体重随机分为5组:正常组、模型组和低中高3个剂量实验组,每组10只。通过创伤和放血构建创伤失血性休克大鼠模型。在建模前30 min,低中高3个剂量(EAA 5,10,15 m L+15,10,5m L 0.9%Na Cl)实验组分别于大鼠消化道内灌注。用HE染色法观察大鼠肠道绒毛形态变化以及肠黏膜损伤程度。复苏后4,8,16 h对大鼠的内毒素、一氧化氮(NO)、肿瘤坏死因子α(TNF-α)水平进行检测。结果与空白组0.03±0.01比较,模型组的肠黏膜损伤指数为5.41±2.56,差异有统计学意义(P<0.05)。复苏4 h后,与模型组比较,高、中、低3个剂量实验组的大鼠肠黏膜损伤指数分别为3.45±0.75,2.53±0.68,2.02±0.53,差异均有统计学意义(均P<0.05)。与空白组比较,模型组大鼠的血清内毒素、NO、TNF-α水平分别为(456.52±21.56)pg·m L~(-1),(108.41±9.56)ng·m L~(-1),(77.58±10.65)ng·m L~(-1),差异均有统计学意义(均P<0.05)。复苏4 h后,高、中、低3个剂量实验组的大鼠内毒素、NO、TNF-α的水平分别为(280.41±15.42),(254.63±17.56),(221.53±13.53)pg·m L~(-1);(90.43±8.42),(63.54±7.53),(49.52±8.41)ng·m L~(-1);(77.58±10.65),(62.58±5.12),(42.51±4.53)ng·m L~(-1)。与模型组比较,3个剂量实验组的大鼠内毒素、NO水平差异均有统计学意义(均P<0.05);而TNF-α水平只有中低2个剂量实验组差异均有统计学意义(均P<0.05)。结论低浓度EAA能够有效缓解失血性休克引起的应激反应,降低炎症因子水平,从而保护大鼠肠功能。
Objective To investigate the effect of endotoxin affinity adsorbent (EAA) on intestinal damage and inflammatory cytokines in traumatic hemorrhagic shock rats. Methods SD rats were selected and randomly divided into 5 groups according to body weight: normal group, model group and low, medium and high dose three experimental groups, 10 in each group. Traumatic and hemopoietic models of traumatic hemorrhagic shock in rats were established. At 30 min before modeling, experimental groups of low, medium and high doses (EAA 5, 10, 15 m L + 15, 10, 5 m L, 0.9% Na Cl) were respectively perfused in the digestive tract of rats. The morphological changes of intestinal villus and the degree of intestinal mucosal injury were observed by HE staining. The levels of endotoxin, nitric oxide (NO) and tumor necrosis factor α (TNF-α) were detected at 4, 8 and 16 h after resuscitation. Results Compared with the blank group 0.03 ± 0.01, the intestinal mucosa injury index of the model group was 5.41 ± 2.56, the difference was statistically significant (P <0.05). At 4 h after resuscitation, compared with the model group, the intestinal mucosal injury index of rats in the high, middle and low dose groups were 3.45 ± 0.75, 2.53 ± 0.68 and 2.02 ± 0.53, respectively, with statistical significance (P <0.05). Compared with the blank group, the levels of endotoxin, NO and TNF-α in the model group were (456.52 ± 21.56) pg · m L -1, (108.41 ± 9.56) ng · m L -1 ), (77.58 ± 10.65) ng · m L -1, all of which were significantly different (all P <0.05). After resuscitation for 4 h, the levels of endotoxin, NO and TNF-α in high dose, middle dose and low dose groups were (280.41 ± 15.42), (254.63 ± 17.56) and (221.53 ± 13.53) pg · m (-1); (90.43 ± 8.42), (63.54 ± 7.53), (49.52 ± 8.41) ng · m L -1; (77.58 ± 10.65), (62.58 ± 5.12), (42.51 ± 4.53) ) ng · m L ~ (-1). Compared with the model group, the levels of endotoxin and NO in the three doses of the experimental group were significantly different (all P <0.05), while the levels of TNF-αin the low and middle dose groups were all significantly different (All P <0.05). Conclusions EAA at low concentration can effectively relieve the stress response induced by hemorrhagic shock, reduce the level of inflammatory cytokines and protect the intestinal function in rats.