迷走神经兴奋对内毒素休克兔生命体征的影响  

Effects of vagus nerve stimulation on endotoxic shock in rabbits

作　　者：郑崇明[1] 左祥荣[1] 刘少华[1] 曹权[1] 徐鑫荣[1] 

机构地区：[1]南京医科大学第一附属医院ICU,南京210029

出　　处：《中华急诊医学杂志》2009年第11期1190-1193,共4页Chinese Journal of Emergency Medicine

摘　　要：目的 探讨电刺激迷走神经对内毒素（lipopolysaccharide，LPS）休克兔生命体征变化的影响。方法16只兔随机分为刺激组（S组）和对照组（C组）。两组均切断双侧颈迷走神经干，按600μg/kg静注大肠杆菌LPS。S组选择左迷走神经近心端接刺激电极，在注射LPS前后各持续电刺激（电压10v，频率5Hz，波宽5ms）10min。分别于输注LPS前及后30，60，120，180，240和300min记录心率（HR）和平均动脉压（MABP），检测虹清中肿瘤坏死因子（TNF-α）和白介素10（IL-10）含量。结果兴奋迷走神经能缓解LPS引起的低血压休克，同时与C组比较，S组血清中TNF-α显著降低[（38．12±7．85）pg／mL．（55．12±7．89）pg／mL，P〈0．01]而IL-10水平明显升高[（55．12±9．37）pg／mL vs．（40．15±5．44）pg／mL，P〈0．01]。结论兴奋迷走神经可以改善LPS休克兔的生命体征，这种现象可能与迷走神经影响体内炎症介质的合成有关。Objective To study the effects of electrical stimulation of efferent vagus nerve on the endotoxic shock in rabbits. Method Sixteen Newzealand rabbits were randomly divided into 2 groups, namely group S as the stimulation group and group C as the control group）. Rabbits were subjected to bilateral cervical vagotomy and had challenge with intravenous injection of lipopolysaccharide （LPS） （E. COH O111 ： B4 , DIFCO, USA） in a dose of 600μg/kg. The distal end of the left vagus nerve trunk was connected to an electric stimulator with bipolar electrode and controlled by an acquisition system. Stimuli with stable voltage （ 10V,5 Hz,5 ms） were apphed twice to the nerve for 10 minutes just before and after the administration of LPS in group S. At the time before and after the infusion of LPS 30 min,60 min, 120 min, 180 rain,240 min and 300 min respectively, the heart rate（HR） and the mean arterial blood pressure （MABP） in each animal were recorded, and blood samples were taken for measuring serum tumor necrosis factor-α（TNF-α） and interleukin-10 （IL-10）. Results Compared with group C, the electrical stimulation of efferent vagus nerve could significantly attenuated the LPS-induced hypotension and decreased the contents of TNF-α [ （38.12 ± 7.85） pg/mL vs. （55.12± 7.89） pg/mL, P 〈 0.01], but increased the contents of IL-10 [ （55.12±9.37） pg/mL vs. （40.15 ± 5.44） pg/mL, P 〈 0.01 ] after LPS challenge. Conclusions The stimulation of the efferent vagus nerve can down-regulate systemic TNF-α production and attenuate the development of shock after LPS challenge.

关 键 词：内毒素休克 平均动脉压 肿瘤坏死因子-α 胆碱能抗炎通路 

分 类 号：R459.7[医药卫生—急诊医学]