乌司他丁对重度创伤失血性休克大鼠肠道屏障的影响

目的探讨应用乌司他丁对重度创伤失血性休克大鼠进行复苏对肠道屏障的影响。方法 70只SD大鼠,随机分为3组:假休克组(SS组)、乳酸林格液复苏组(LRS组)、乳酸林格液+乌司他丁复苏组(LRS+UTI组)。LRS组、LRS+UTI组各取12、24、48h3个时间点,LRS组将血液回输并输入两倍量的乳酸林格氏液进行复苏,LRS+UTI组50000U·kg-1·d-1UTI加入乳酸林格氏液内输注。用ELISA试剂盒检测各组不同时间点血浆中DAO、ET的水平。结果 (1)LRS组与LRS+UTI组12、24、48h3个时间点其DAO值均高于SS组(P<0.05),LRS组在24h达高峰,其后下降,但降幅较小,而LRS+UTI组在复苏后24h即出现明显下降趋势,复苏48h后明显下降。LRS+UTI组与LRS组相比24、48hDAO含量差异有统计学意义(P<0.05)。(2)LRS组与LRS+UTI组12、24、48hET值均高于SS组(P<0.05),LRS组在24h达高峰,其后下降,下降幅度较小,而LRS+UTI组24、48h下降明显。LRS+UTI组与LRS组相比在24、48hET值差异有统计学意义(P<0.05)。结论应用乌司他丁复苏创伤-失血性休克,可有效降低肠屏障功能的损伤,减轻肠黏膜的通透性,减轻细菌及内毒素移位。

Influence of ulinastatin on intestinal mucosal barrier of rats with severe traumatic-hemorrhagic shock

Objective To investigate the effect of ulinastatin（UTI） on intestinal mucosal barrier of rats with severe traumatic-hemorrhagic shock.Methods 70 male SD rats were randomly divided into three groups,sham-shock group（SS group）,lactated Ringer＇s group（LRS group） and ulinastatin（UTI） group（LRS＋UTI group）.After traumatic hemorrhagic shock was induced,the rats in LRS group received shed blood volume and two times of the shed blood volume of lactated Ringer＇s solution within 30min.The rats in LRS＋UTI group were infused with Ringer＇s solution plus 50 000 U·kg-1·d-1 UTI.The levels of DAO and ET were detected by ELISA method at three time points（12h,24h,48h）,respectively.Results The DAO levels in LRS group and LRS＋UTI group at 12h,24h,48h after resuscitation were significantly higher than those in SS group（P0.05）,which in LRS group reached peak at 24h,then slowly decreased,however,which in LRS＋UTI group were decreased obviously 24h after resuscitation,and the decrease tendency was more obvious 48h after resuscitation.There were significant differences in the levels of DAO at 24h,48h between LRS＋UTI group and LRS group（P0.05）.The ET levels in LRS group and LRS＋UTI group at 12h,24h,48h after resuscitation were significantly higher than those in SS group（P0.05）,which in LRS group reached peak at 24h,then slowly decreased,however,which in LRS＋UTI group decreased obviously at 24h,48h after resuscitation,and there were significant differences in the levels of ET at 24h,48h between LRS＋UTI group and LRS group（P0.05）.Conclusion The application of ulinastatin in the treatment of traumatic hemorrhagic shock can effectively relieve the injury of intestinal mucosal barrier function,alleviate the permeability of intestinal mucous membrane and can lessen the displacement of bacteria and endotoxin.