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乌司他丁联合抗菌药对创伤弧菌脓毒症大鼠心肌的保护作用
引用本文:孙来芳,徐俊南,曾潍贤,潘小东,龚裕强,应斌宇. 乌司他丁联合抗菌药对创伤弧菌脓毒症大鼠心肌的保护作用[J]. 中华危重症医学杂志(电子版), 2012, 5(5): 296-302
作者姓名:孙来芳  徐俊南  曾潍贤  潘小东  龚裕强  应斌宇
作者单位:温州医学院附属第二医院急诊科;温州医学院附属第二医院ICU
基金项目:温州市科技局基金项目(Y2005A016)
摘    要:目的观察创伤弧菌脓毒症大鼠的心肌酶变化及心肌超微结构的病理改变,探讨乌叫他厂联合抗菌药物对创伤弧菌脓毒症大鼠心肌损伤的干预作用。方法对60只成年雌性大鼠采用腹腔内注射创伤弧菌悬液建立脓毒症模型,将其分为四组,每组15只,分别为胀毒症对照组(C组)、氧氟沙星治疗组(K组)、乌司他丁治疗组(u组)、乌司他丁联合氧氟沙早治疗组(L组)。C组大鼠出现休克症状后观察各组大鼠心肌组织透射电镜下超微结构改变。H时留取血液标本,采用酶联免疫吸附剂测定法行心肌酶学检测。结果L组_人冬氰酸转氨酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)值均明显低于其他三组(P均〈0.01)。K组、U组仅CK值显著低于C组(P均〈0.01),而其AST、LDH、HBDH水平与C组比较均无统计学意义(P均〉0.05);U组与K组AST、CK、LDH、HBDH的水平差异无统计学意义(P均〉0.05)。C组大鼠心肌细胞的超微结构病变最重,K组心肌纤维的超微结构改变较少,U组心肌纤维的超微结构改变较K组多,而L组心肌纤维的结构基本正常。结论乌司他丁伍用抗菌药治疗对创伤弧菌脓毒症大鼠急性心脏损伤具有明显的保护作用。

关 键 词:脓毒症  弧菌  创伤  心脏损伤  乌司他丁

Protective effects of ulinastatin combined with antibiotic on myocardial injury induced by Vibrio vulnificus sepsis in rats
SUN Lai-fang, XU Jun-nan, ZENG Wei-xian, PAN Xiao-dong, GONG Yu-qiang, YING Bin-yu. Protective effects of ulinastatin combined with antibiotic on myocardial injury induced by Vibrio vulnificus sepsis in rats[J]. Chinese Journal of Critical Care Medicine ( Electronic Editon), 2012, 5(5): 296-302
Authors:SUN Lai-fang   XU Jun-nan   ZENG Wei-xian   PAN Xiao-dong   GONG Yu-qiang   YING Bin-yu
Affiliation:. *Department of Emergency Medicine, The Second Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, China
Abstract:Objective To observe the changes of the serum myocardial enzymes, the pathogenic changes of myocardial ultrastructure in rats with Vibrio vulnificus sepsis, and investigate the intervention of ulinastatin combined with antibiotic on myocardial cell injury induced by Vibrio vulnificus sepsis in rats. Methods Vibrio vulnificus sepsis model was induced by intraperitoneal injection of Vibrio vuinificus with concentration of 3.0 × 10^8 cfu / ml, in dose of 0.5 ml / kg in rats. Sixty female SD rats were randomly allocated into 4 groups, 15 in each: sepsis control group (group C), ofloxacin treatment group (group K), Ulinastatin treatment group (group U), Ulinastatin and ofloxacin combined treatment group (group L). The pathogenic changes of myocardial uhrastructure were observed in a transmission electron microscope after shock in rats of the sepsis control group. The bloodsamples were obtained from jugular vein, and the serum myocardial enzymes were testedby enzyme linked immunosorbent assay. Results In group L, the serum enzymes including aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), were significantly lower than those in the other groups (all P 〈 0.01). As compared to the group C, only the concentration of CK was obviously lower in the K and U groups (all P 〈 0.01), while the levels of AST, LDH, HBDH showed no significant difference (all P 〉 0.05). There were no statistical significance in AST, CK, LDH and HBDH between the U and K groups (all P 〉 0.05). As to the pathogenic change of myocardial ultrastructure, it was the heaviest in rats of the group C, slightest of group K, a bit heavier of group U than group K. In group L, myocardial ultrastructure was almost normal. Conclusion The combination of Ulinastatin and antibiotic take obvious protective effects on the acute myocardial injury induced by Vibrio vulnificus sepsis in SD rats.
Keywords:Sepsis  Vibrio vulnificus  Heart injuries  Ulinastatin
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