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目的探讨参附液对失血性休克大鼠小肠道粘膜屏障的影响及其可能机制。方法成年健康雄性Wistar大鼠30只,随机分为对照组(C group)、参附预处理组(PS group)和参附治疗组(SF group),每组10只。三组均复制失血性休克模型,经一侧股动脉放血,对侧测压,当平均动脉压降至35mmHg后,维持1h后,C组和SF组分别经股静脉回输等失血量的乳酸林格氏液和参附液,而PS组在放血前30min先经股静脉输注参附液5ml/kg预处理,余处理同C组。18h后处死动物取标本。偶氮基质显色鲎试验(LAL)定量测定血浆内毒素含量,免疫组化SABC法测定小肠粘膜固有层IgA+细胞数量,TUNEL法检测小肠粘膜凋亡细胞数量,并计算凋亡指数。ELISA法测定血浆IL-6的含量。结果PS和SF组内毒素含量、细胞凋亡指数及IL-6水平明显低于C组(P<0.01),而IgA+细胞数量显著高于C组(P<0.01);PS与SF组相比,IgA+细胞数量在SF组稍低(P<0.05)。结论参附对失血性休克导致肠道粘膜屏障功能有保护作用,可增加小肠粘膜固有层IgA+的含量,降低血浆内毒素含量、粘膜细胞凋亡指数及IL-6水平。
Objective To investigate the effect of Shenfu solution on intestinal mucosal barrier in rats with hemorrhagic shock and its possible mechanism. Methods Thirty adult male Wistar rats were randomly divided into control group (C group), PS group and SF group (n = 10 in each group). The hemorrhagic shock model was replicated in all three groups. One side of the femoral artery was bled and contralateral manometry was performed. When the mean arterial pressure was reduced to 35 mmHg and maintained for 1 hour, the C and SF groups received blood transfusions such as femoral venous return. Ringer’s solution and Shenfu’s solution, while the PS group was pretreated with 5 ml/kg of the femoral vein infusion before 30 minutes before blood transfusion. The rest of the treatment was the same as that of the C group. After 18 hours, animals were sacrificed for specimen collection. The azo matrix chromogenic test (LAL) was used to quantify the plasma endotoxin content. The immunohistochemical SABC method was used to determine the number of IgA+ cells in the intestinal mucosal lamina propria. The TUNEL method was used to detect the number of apoptotic cells in the intestinal mucosa and the apoptosis index was calculated. Plasma IL-6 levels were determined by ELISA. Results The endotoxin content, apoptotic index, and IL-6 level in PS and SF groups were significantly lower than those in group C (P<0.01), while the number of IgA+ cells was significantly higher than that in group C (P<0.01); PS was compared with SF group. The number of IgA+ cells was slightly lower in the SF group (P<0.05). Conclusion Shenfu has protective effect on hemorrhagic shock and intestinal mucosal barrier function. It can increase the content of IgA+ in the intestinal lamina propria, reduce the plasma endotoxin content, mucosal cell apoptosis index and IL-6 level.