失血性休克后的肠淋巴液提高血管通透性的作用  

Role of post-hemorrhagic shock mesenteric lymph in enhancement of vascular permeability

作　　者：孙改霞[1] 郭亚雄[1] 杜会博[1] 张立民[1] 赵自刚[1] 刘圣君[1] 牛春雨[1] 

机构地区：[1]河北北方学院微循环研究所,河北张家口075000

出　　处：《中国病理生理杂志》2014年第8期1506-1512,1536,共8页Chinese Journal of Pathophysiology

基　　金：河北省高校百名创新人才支持计划(Ⅱ)

摘　　要：目的：观察失血性休克肠后的淋巴液（PHSML）在血管高通透性中的作用。方法：18只雄性Wist-ar大鼠随机均分为假手术组、休克组和休克＋引流组。休克组与休克＋引流组复制失血性休克模型[（40±2） mmHg，90 min]，行液体复苏；休克＋引流组在复苏结束后，引流休克肠淋巴液至6 h，观察PHSML引流对休克大鼠各组织血管通透性的影响。随后，将引流至体外的 PHSML 与人脐静脉内皮细胞（ HUVECs ）共孵育6 h，观察PHSML对HUVECs形态以及单层细胞通透性的影响。结果：休克组大鼠肺、心肌、肾、肝、脾和小肠外观的蓝色程度、组织伊文氏蓝含量均显著高于假手术组，干湿重比值显著低于假手术组；PHSML引流逆转了这些指标的变化。进一步发现，4％和10％PHSML 0～3 h、3～6 h以及脂多糖（10 mg/L）均引起了HUVECs的形态学损伤，降低了细胞活性与跨细胞电阻，增加了对异硫氰酸荧光素标记白蛋白的通透性。结论：PHSML是血管通透性增加的一个重要因素。AIM： To investigate the role of post-hemorrhagic shock mesenteric lymph （PHSML） in the enhancementof vascular permeability .METHODS： Eighteen Wistar rats were randomized into sham group , shock group,and shock plus mesenteric lymph drainage （shock ＋drainage） group.The rats in shock group and shock ＋drainagegroup were routinely subjected to hemorrhagic shock and hypotension [（40 ±2） mmHg] was maintained for 90 min, andthen the fluid resuscitation was performed.Mesenteric lymph was drained in the rats in shock ＋drainage group from resuscitationfinished to 6 h, for the observation of PHSML drainage on the vascular permeability in multiple tissues of hemorrhagicshock rats.Afterwards, human umbilical vein endothelial cells （HUVECs） were incubated with the PHSML in vitro to observethe effects of PHSML on the morphology and permeability of HUVECs .RESULTS： The degree of blue color and concentrationsof Evens blue in the lung, myocardium, kidney, liver, spleen and small intestine were significantly increased inthe shocked rats than that in sham group, while the ratios of the dry weight to the wet weight were decreased .The mesentericlymph drainage reversed these changes .Meanwhile, 4% and 10% of PHSML at 0 ~3 h and 3 ~6 h after resuscitation,and lipopolysaccharide （10 mg/L） all caused the damage of HUVECs, decreased the viability and trans-endothelial electricalresistance of HUVECs, and increased the permeability of HUVECs to fluorescein isothiocyanate -labeled albumin. CONCLUSION： PHSML is a vital factor in the enhancement of vascular permeability .

关 键 词：休克 出血性 肠淋巴液 血管通透性 人脐静脉内皮细胞 引流术 

分 类 号：R364.14[医药卫生—病理学] R331.4[医药卫生—基础医学]