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目的探讨高渗氯化钠羟乙基淀粉40注射液(HSH)小容量复苏对内毒素休克大鼠小肠损伤的影响。方法清洁级SD大鼠30只随机分为5组:正常对照组(N组)、内毒素休克组(E组)、7.5%高渗氯化钠组(HTS组)、羟乙基淀粉130/0.4氯化钠注射液组(HES组)和高渗氯化钠羟乙基淀粉40注射液组(HSH组)。静注脂多糖(LPS)1 mg·kg~(-1)制作休克模型,30 min后分别予不同液体小容量复苏(4 mL·kg~(-1))。90 min后处死大鼠,HE染色观察小肠病理变化,取小肠组织检测硫化氢(H_2S)、一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子α(TNF-α)。结果内毒素休克大鼠小肠出现明显的病理改变,如黏膜断裂,上皮细胞水肿、脱落,肠内出血,炎症浸润等,而不同液体小容量复苏组的上述改变则有不同程度减轻,HSH组肠组织损伤分级评分显著低于HTS组(P<0.05),略低于HES组,但无显著差异(P>0.05)。E组大鼠小肠匀浆液中H_2S、NO和TNF-α含量及MDA较N组显著增高(P<0.05),SOD活性显著下降(P<0.05);3种液体复苏组与E组比较,H_2S、NO和TNF-α含量及MDA水平显著降低,SOD活性显著增高(均P<0.05)。HSH组H_2S和NO含量明显低于HTS组和HES组(P<0.05);HSH组TNF-α含量和MDA水平明显低于HTS组,SOD活性明显高于HTS组(P<0.05),但均与HES组无显著差异(P>0.05)。各组大鼠小肠干湿重比未见有明显差异(P>0.05)。结论内毒素休克大鼠使用HTS、HES、HSH三种液体小容量复苏后,小肠的炎症、氧化应激、病理损伤有不同程度减轻。HSH复苏效果明显优于HTS,与HES无显著差异。
Objective To investigate the effect of hypertonic sodium chloride hydroxyethyl starch 40 (HSH) small volume resuscitation on small intestine injury induced by endotoxin in rats. Methods Thirty SD rats were randomly divided into five groups: normal control group (N group), endotoxin shock group (E group), 7.5% hypertonic sodium chloride group (HTS group), hydroxyethyl starch 130 / 0.4 sodium chloride injection group (HES group) and hypertonic sodium chloride hydroxyethyl starch 40 injection group (HSH group). The model of shock was established by intravenous injection of lipopolysaccharide (LPS) 1 mg · kg ~ (-1). After 30 min, small fluid resuscitation (4 mL · kg ~ (-1)) was performed. After 90 min, the rats were sacrificed and the pathological changes of the small intestine were observed by HE staining. The contents of H 2 S, NO, SOD, MDA, Tumor Necrosis Factor α (TNF-α). Results The pathological changes of small intestine in endotoxic shock rats such as mucosal rupture, epithelial cell edema, exfoliation, intestinal hemorrhage and inflammatory infiltration were observed. However, the above changes in different liquid small volume resuscitation groups were alleviated to some extent. The intestinal tissue of HSH group The grading score of injury was significantly lower than that of HTS group (P <0.05), but slightly lower than that of HES group (P> 0.05). The content of H 2 S, NO and TNF-α and the content of MDA in E group were significantly higher than those in N group (P <0.05) and SOD activity (P <0.05). Compared with E group, , The content of NO and TNF-α, the level of MDA and the activity of SOD were significantly increased (all P <0.05). The contents of H 2 S and NO in HSH group were significantly lower than those in HTS group and HES group (P <0.05). The levels of TNF-α and MDA in HSH group were significantly lower than those in HTS group There was no significant difference with HES group (P> 0.05). The wet and dry weight of small intestine of rats in each group showed no significant difference (P> 0.05). Conclusions The endotoxin shock rats using HTS, HES, HSH three kinds of liquid small volume recovery, the small intestine inflammation, oxidative stress, pathological damage to varying degrees reduce. HSH recovery was significantly better than HTS, and HES no significant difference.