肠淋巴液引流减轻失血性休克大鼠脾组织损伤的作用与机制

 目的：观察肠淋巴液引流对失血性休克大鼠脾组织形态、细胞凋亡、细胞周期与增殖指数的影响，探讨肠淋巴液在休克发病学中的意义。方法: 在休克组与休克+引流组大鼠中复制失血性休克模型，低血压1.5 h后行液体复苏，休克+引流组大鼠于低血压1 h起引流休克肠淋巴液至液体复苏结束后3 h。留取固定位置的脾组织，HE染色观察脾组织形态，Hoechst 33258染色观察细胞凋亡，免疫组织化学染色检测Bcl-2和Bax蛋白表达，流式细胞术检测细胞周期和p53蛋白表达，计算增殖指数。结果：与假手术组比较，休克组大鼠脾组织出现了形态学损伤，凋亡细胞显著减少，Bax与p53蛋白表达显著升高，Bcl-2表达下降；休克+引流组大鼠脾组织G2/M期细胞数显著增多。与休克组比较，休克+引流组大鼠脾组织的损伤程度较轻，凋亡细胞和G0/G1期细胞显著减少，Bax与p53表达显著降低，G2/M期细胞显著增多，Bcl-2表达与增殖指数显著升高。结论: 休克肠淋巴液引流减轻了失血性休克大鼠的脾损伤，其作用机制可能与减少脾细胞凋亡有关。

Mesenteric lymph drainage alleviates spleen injury in hemorrhagic shock rats

AIM：To observe the effects of post-shock mesenteric lymph (PSML) drainage on histopathology, apoptosis, cell cycle and proliferation of the spleen in rats with hemorrhagic shock. METHODS：Eighteen Wistar rats were randomly divided into sham, shock and shock+drainage groups (n=6 in each group). The hemorrhagic shock model was established in the shock and shock+drainage groups. Fluid resuscitation for 30 min was performed 1.5 h after hypotension, and PSML was drained in the rats in shock+drainage group from 1 h after hypotension to 3 h after resuscitation finished. The fixed spleen tissue was harvested from each rat for histological observation with HE staining. The apoptosis of splenocytes was observed by Hoechst 33258 staining. The expression of Bcl-2 and Bax proteins was detected by immunohistochemical staining. The cell cycle and the expression of p53 protein were measured by flow cytometry, and the proliferation index (PI) was calculated. RESULTS：Compared with sham group, splenic tissue injury appeared in the shocked rats. The apoptotic cells and the expression of Bax and p53 in shock group were increased, while Bcl-2 expression was decreased. The percentage of G2/M cells in shock group was decreased. Compared with shock group, the splenic tissue damage in shock+drainage group was significantly attenuated. Moreover, the number of apoptotic cells, the percentage of G0/G1 cells, and the expression of Bax and p53 were obviously decreased, and the G2/M cells, Bcl-2 protein expression and PI were significantly increased in shock+drainage group. CONCLUSION: PSML drainage alleviates splenic injury in hemorrhagic shock rats, which may be related to reducing the apoptosis of splenocytes.