前列腺素E1预处理对失血性休克复苏后大鼠肝损伤的保护作用  

The protective effects of pretreatment with Lipo-PGE1 on liver injury after hemorrhagic shock andresuscitation in rats

作　　者：林洁[1] 李建英[2] 韦立新[3] 黄月红[4] 陈治新[4] 

机构地区：[1]福建医科大学协和临床医学院,福州350001 [2]福建医科大学附属协和医院消化内科 [3]福建医科大学附属协和医院检验科 [4]福建医科大学附属协和医院消化内科研究所

出　　处：《中华急诊医学杂志》2011年第5期502-506,共5页Chinese Journal of Emergency Medicine

摘　　要：目的探讨前列腺素E1脂微球制剂（Lipo－PGEl）预处理对失血性休克复苏后大鼠肝损伤的保护作用及机制。方法32只健康雄性sD大鼠随机（随机数字法）分为4组（n=8），A：假手术组：B：休克组，休克90min后处死；C：失血性休克复苏组，大鼠麻醉后，经股动脉穿刺置管放血，使平均动脉压（MAP）降至（35±5）mmHg，维持90min，回输自体血液复苏，维持MAP80—100mmHg，制作失血性休克复苏模型；D：失血性休克复苏＋Lipo—PGE1预处理组，Lipo—PGEI按10μg/kg溶于0．5mL生理盐水从股静脉注射，1h后制作失血性休克复苏模型。C组和D组于复苏后6h取血测肝功及NO、ET-1，HE染色观察肝组织病理变化，免疫组化检测肝组织iNOS和ET－1的表达。数据采用单因素方差分析，以P〈0．05为差异具有统计学意义。结果失血性休克复苏组肝脏发生严重缺血一再灌注损伤，ALT，AST，LDH及NO，ET-1较休克组均有不同程度升高（P〈0．05），肝组织iNOS和ET－1的表达显著高于休克组[（0．225±0．080）VS．（0．082±0．021），（0．292±O．047）VS．（0．082±0．035），P〈0．05]；预先给药组肝脏病理损伤较模型组轻，ALT，AST，LDH及NO，ET-1较模型组均有不同程度降低（P〈0．05），肝组织iNOS和ET—1的表达明显低于模型组[（0．116±0．034）VS．（0．225±0．080），（0．198±0．041）VS．（0．292±0．047），P〈0．05]。结论Lipo—PGE1预处理可以减轻失血性休克复苏后大鼠肝损伤，其机制可能与抑制肝组织iNOS和ET-1的表达，调节NO／ET-1的平衡有关。Objective To observe the effects and mechanism of pretreatment in rats with prostaglandin El on liver after hemorrhagic shock and resuscitation（HSR）. Method In total, 32 male SD rats were randomly （ random number） divided into four groups （ u = 8 ） ： group A （ sham group） , group B （ shock group） , group C （HSR group） and group D （Lipo-PGE1 ＋ HSR）. In group B, rats were sacrificed 90 rain after shock, and in group C, rats were anesthetized and then subjected to hemorrhagic shock followed by re- suscitation. In group D, rats were pretreated with Lipo-PGE1 one hour before HSR. Liver function, NO and ET-1 were measured, and pathological changes of liver tissue in each group were observed, and the expres- sions of iNOS and ET-1 of liver tissue were measured by using immunohistochemistry 6 hours ＇after HSR. Da- ta were analyzed by analysis of variance, and P 〈 0.05 was considered as significantly different in statitis- tics. Results The levels of liver iNOS and ET-I increased in HSR group compared with shock group [（0.225±0.080） vs. （0.082±0.021） and （0.292±0.047） vs. （0.082±0.035）, P〈0.05 ]. Pre- treatment with Lipo-PGE1 markedly reduced the damage of Liver function, and lowered the levels of NO and ET-1, which were consistent with decrease in iNOS and ET-1 6 hours after HSR [ （0. 116±0. 034） vs. （0.225±0.080） and （0.198±0.041） vs. （0.292±0.047）, P〈0.05]. Conclusions Pretreatmentwith Lipo-PGE1 could reduce liver injury after HSR. The mechanisms might be attributed to inhibiting iNOS and ET-1, regulating the balance of NO/ET-1.

关 键 词：前列腺素E1 失血性休克 缺血一再灌注损伤 肝脏 

分 类 号：R459.7[医药卫生—急诊医学]