參附注射液對敗血性休克大鼠心肌損傷的影響

目的:觀察參附注射液對敗血性休克大鼠心肌損傷的保護作用并探討其可能機制。方法:Wistar大鼠隨機分為假手術組(C)、休克組(S)、參附治療組(SF),各組均為 16 只。采用改良的盲腸結扎穿孔(CLP)方法復制敗血性休克模型,觀察術后6 h和18 h的心肌組織病理改變;免疫組織化學技術檢測心肌組織中核轉錄因子 κB(NF κB)、細胞間粘附分子 1(ICAM 1)的表達和分布;用ELISA法檢測血漿中腫瘤壞死因子 α(TNF α)、白細胞介素 10(IL 10)的含量,連續監測動脈壓及心率變化。結果:較之C組, 6 h時S組大鼠動脈壓即明顯下降,心率增快(P<0.01),到18 h心率、動脈壓均極度降低(P<0.01),而SF組18 h才出現 MAP下降(P<0.05)。與同時點 S組比較,SF組心肌組織病理損害明顯減輕;SF組CLP后心肌組織 NF κB及 ICAM 1 的陽性表達比 S組明顯降低(P<0.01);SF組血漿中TNF α含量較S組明顯降低(P<0.01),18 h時 IL 10 含量較 S組明顯降低(P<0.01)。結論:參附注射液能抑制敗血性休克后心肌組織NF κB的活化及ICAM 1、TNF α、IL 10的表達從而起到心肌保護的作用。

Effects of Shenfu Injection on Myocardial Injury in Rats with Septic Shock

Objective: To investigate the protective effects of Shenfu injection (SF), a traditional Chinese medicine, on myocardial injury in rats with septic shock and the possible mechanisms. Methods: 48 Wistar rats were randomly divided into 3 groups with 16 in each group: sham-operation group(C group) only underwent laparotomy; septic shock group(S group) underwent cecal ligation and punctures (CLP); and Shenfu treated group (SF group) received Shenfu injection 8 ml·kg –1 ·h –1 intravenously followed by CLP. Each group was further divided into 2 subgroups: 6 h and 18 h subgroups according to the time when blood samples were taken and the rats were sacrificed. Myocardium samples of rats’ left ventricle were extracted for observation under optical microscope. Immunohistochemical staining method of SP was used to locate the expression and distribution of NF-κB and ICAM-1 in myocardium. The plasma levels of TNF-α and IL-10 were determined by enzyme-linked immunoadsordent assay (ELISA). Right femoral artery and vein were cannulated for mean artery pressure (MAP) monitoring and fluid infusion. Results: Compared with that in C group, MAP gradually decreased and heart rate gradually increased at 6 h after CLP in S group(P<0.01). And at 18 h, both MAP and heart rate markedly decreased(P< 0.01 ). However, MAP begin to decrease at 18 h in SF group(P<0.05). There were less myocardial injuries in SF group than in S group at the same stage. SF could significantly inhibit the activation of NF-κB and the expression of ICAM-1 in myocardium and decreased the concentration of TNF-α and IL-10 in plasma after CLP, compared with that in S group(P<0.01). Conclusion: Shenfu injection could protect myocardium from the injury induced by septic shock through inhibiting the activity of NF-κB and the expression of ICAM-1, TNF-α and IL-10.