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目的:观察创伤性休克后大鼠肝组织诱导型一氧化氮合酶(iNOS)mRNA的表达动态变化及盐酸戊乙奎醚(PHC)的干预影响,探讨PHC对创伤性休克继发肝损伤的保护机制。方法:RT-PCR法检测对照组(C组)、休克组(S组)、PHC小剂量组(P1组)和PHC大剂量组(P2组)肝组织iNOS mRNA表达;观察肝组织病理改变并测定血清ALT、AST水平。结果:S组、P1组和P2组大鼠肝组织iNOS mRNA表达于复苏后2h即有增加,6h达高峰,复苏后24h仍高于对照组(P均<0.05)。P2组复苏后各时相点及P1组复苏后2h、6h肝组织iNOS mRNA表达较S组明显减低;P2组6h iNOS mRNA表达明显低于P1组(P均<0.05)。P2组复苏后各时相点及P1组复苏后2h和6h的血清ALT和AST水平较S组明显降低(P均<0.05)。光镜下P2组肝组织病理损害减轻的程度较P1组更明显。结论:PHC可减轻创伤性休克后继发的肝脏损害,大剂量PHC作用更强,其机制可能与降低肝组织iNOS mRNA表达有关。
OBJECTIVE: To observe the dynamic changes of iNOS mRNA expression and the intervention effect of pemetrexed hydrochloride (PHC) in rats after traumatic shock, and to investigate the effect of PHC on hepatic injury induced by traumatic shock protection mechanism. Methods: The expression of iNOS mRNA in liver tissue of control group (C group), shock group (S group), PHC low dose group (P1 group) and PHC high dose group (P2 group) were detected by RT-PCR. Serum ALT, AST levels were measured. Results: The expression of iNOS mRNA in the liver tissue of S group, P1 group and P2 group increased at 2h after resuscitation, reached the peak at 6h, and remained higher than that of control group 24h after resuscitation (all P <0.05). The expression of iNOS mRNA in liver tissue in P2 group was significantly lower than that in S group at 2 h and 6 h after resuscitation. The expression of iNOS mRNA in P2 group was significantly lower than that in P1 group at 6 h (P <0.05). Serum levels of ALT and AST in P2 group after resuscitation at 2 h and 6 h after resuscitation were significantly lower than those in S group (all P <0.05). Under light microscope, the degree of pathological damage lesion in P2 group was more obvious than that in P1 group. CONCLUSION: PHC can relieve hepatic injury secondary to traumatic shock. PHC has a stronger effect than high-dose PHC, and its mechanism may be related to the decrease of iNOS mRNA expression in liver tissue.