肠系膜淋巴管结扎对失血性休克大鼠的器官保护作用  

Protecting effect of mesenteric lymph duct ligation on vital organs of rats wit±h hemorrhagic shock

作　　者：刘勇军[1] 毛恩强[2] 欧阳彬[1] 陈娟[1] 汤耀卿[2] 管向东[1] 

机构地区：[1]中山大学附属第一医院SICU,广东广州510080 [2]上海交通大学医学院附属瑞金医院SICU

出　　处：《中国危重病急救医学》2009年第5期274-277,I0001,共5页Chinese Critical Care Medicine

基　　金：广东省自然科学基金项目（06021341）;上海市医药卫生科技发展基金项目（034074）

摘　　要：目的观察肠系膜淋巴管结扎对失血性休克大鼠肠、肝、肺组织细胞因子表达以及组织病理学的影响。方法24只SD大鼠被随机均分成对照组、失血性休克组、失血性休克＋肠系膜淋巴管结扎组。采用逆转录-聚合酶链反应（RT—PCR）检测各组大鼠肠、肝、肺组织肿瘤坏死因子-α（TNF—α）、白细胞介素-6（IL-6）的mRNA表达；苏木素-伊红（HE）染色观察各组织的病理学改变。结果失血性休克大鼠肠、肝、肺组织TNF—α mRNA和IL-6 mRNA表达均较对照组明显升高（TNF—α mRNA：肠0．54±0．07比0．37±0．05，肝1．01±0．06比0．56±0．07，肺0．94±0．07比0．62±0．06；IL-6 mRNA：肠0．89±0．12比0．50±0．09，肝1．07±0．10比0．57±0．12，肺1．09±0．09比0．67±0．06，P均〈0．01）；肠系膜淋巴管结扎可明显降低肠、肝、肺组织TNF—α mRNA和IL-6 mRNA表达（TNF—α mRNA：肠0．47±0．05比0．54±0．07，肝0．81±0．07比1．01±0．06，肺0．80±0．05比0．94±0．07；IL-6 mRNA：肠0．66±0．07比0．89±0．12，肝0．83±0．13比1．07±0．10，肺0．73±0．11比1．09±0．09，P〈0．05或P〈0．01）。组织病理学观察显示，肠系膜淋巴管结扎可明显减轻失血性休克引起的肠黏膜绒毛坏死、脱落；减轻肝细胞变性、坏死；减轻肺水肿和炎性细胞浸润。结论肠系膜淋巴管结扎可降低失血性休克大鼠肠、肝、肺组织细胞因子TNF-α、IL-6的表达及病理损伤程度，对器官功能起保护作用。Objective To investigate the protecting effect of mesenteric lymph duct ligation on cytokine expression and pathological changes in intestine, liver and lung in rats with hemorrhagic shock. Methods Twenty-four Sprague-Dawley （SD） rats were randomly divided into three groups： control, hemorrhagic shock and hemorrhagic shock plus mesenterie lymph duet ligation, with 8 rats in each group. Reverse transcription-polymerase chain reaction （RT-PCR） was used to detect the expressions of tumor necrosis factor-α （TNF-α） mRNA and interleukin-6 （IL-6） mRNA in intestine, liver and lung tissue in three groups. Hematoxylin-eosin （HE） staining was used for the observation of pathological changes in intestine, liver, lung in all groups. Results The TNF-α mRNA and IL-6 mRNA in intestinal, liver, and lung tissues of rats in the hemorrhagic shock group were markedly higher than those in control group （TNF-α mRNA： intestine 0.54±0. 07 vs. 0.37±0. 05, liver 1. 01±0. 06 vs. 0. 564±0.07, lung 0. 94±0.07 vs. 0.62±0. 06; IL-6 mRNA： intestine 0. 89±0.12 vs. 0. 50±0. 09, liver 1.07±0. 10 vs. 0. 57±0.12, lung 1. 09±0. 09 vs. 0. 67±0. 06, all P〈0. 01）. Mesenterie lymph duet ligation could obviously reduce the expressions of TNF-α mRNA and IL-6 mRNA （TNF-α mRNA： intestine 0.47±0.05 vs. 0.54±0.07, liver 0.81±0.07 vs. 1.01±0.06, lung 0.80±0.05 vs. 0.94±0.07; IL-6 mRNA： intestine 0.66±0.07 vs. 0.89±0.12, liver 0.83±0. 13 vs. 1.07±0.10, lung 0. 73±0. 11 vs. 1.09±0.09, P〈0. 05 or P〈0.01）. Mesenteric lymph duet ligation could markedly attenuate necrosis and exfoliation of the intestinal villi, and it also ameliorated degeneration of liver cells, lung edema and infiltration of inflammatory cells. Conclusion Mesenterie lymph duet ligation can decrease the expressions of TNF-α mRNA and IL-6 mRNA in intestine, liver and lung tissue and attenuate the damage to these organs in rats with hemorrhagic shock. It plays a vital role in protecting the organ functions.

关 键 词：失血性休克 肿瘤坏死因子 白细胞介素 肠系膜淋巴管 大鼠 

分 类 号：R686[医药卫生—骨科学]