乌司他丁对脓毒症大鼠膈肌损伤及生存率的影响  

The effect of ulinastatin on diaphragmatic injury and survival rate among rats with sepsis

作　　者：张海霞[1,2] 丁仲诺 毛燕飞[1] 江来[1] 

机构地区：[1]上海交通大学医学院附属新华医院麻醉与重症医学科,200092 [2]上海交通大学医学院附属新华医院崇明分院麻醉科

出　　处：《国际麻醉学与复苏杂志》2015年第9期819-823,共5页International Journal of Anesthesiology and Resuscitation

基　　金：崇明县卫生计生委科研项目（CW-2014-1）

摘　　要：目的本研究拟观察乌司他丁（ulinastatin，uTI）对脓毒症大鼠膈肌收缩功能、膈肌组织炎性因子和氧化应激指标以及生存率的影响。方法54只清洁级健康雄性Sprague-Dawley（SD）大鼠按完全随机分组法分成3组：假手术组（A组）、盲肠结扎穿孔（cecalligation and puncture，CLP）组（B组）、CLP＋UTI组（C组）；将其中30只sD大鼠按上述分组，每组10只，观察7d生存率；余下24只大鼠按上述分组，每组8只，于术后24h时取膈肌组织，检测膈肌收缩功能，促炎因子肿瘤坏死因子（tumor necrosis factor，TNF）电、白细胞介素（interleukin，IL）-6和氧化应激指标丙二醛（malondialdehyde，MDA）、超氧化物歧化酶（superoxide dismutase，SOD）的含量。结果B组大鼠7d生存率较A组明显降低（20％比100％）（P〈0．05），而UTI治疗可显著改善CLP大鼠生存率（60％比20％）（P〈0．05）。C组大鼠膈肌在各个频率刺激下的张力及最大强直肌力明显高于B组（P〈0．01）。C组与B组比较，促炎因子TNF-α[（6．4±1．8）、（10．4±1．9）ng/g]和IL-6[（55±8）、（81±9）ng／g]水平显著降低，氧自由基MDA含量[（15．6±3．6）、（21．3±4．5）μmol／g]显著降低，SOD[（460±57）、（405±32）ng／g]消耗明显减少，差异有统计学意义（P〈0．05）。结论应用UTI治疗可改善脓毒症大鼠膈肌收缩功能，可能与其降低膈肌组织促炎因子TNF-α和IL-6水平，并减少膈肌内氧自由基MDA的释放、降低SOD的消耗有关；UTI治疗可明显提高脓毒症大鼠的生存率。Objective To investigate the effect of ulinastatin （UTI） on diaphragmatic contractile function,inflammatory cytokines,oxidative stress parameters and survival rate variation among rats with spesis. Methods Fifty-four male Sprague-Dawley （SD） rats were randomly assigned into three groups： Sham-operated group（group A ）, cecal ligation and puncture（CLP） group（group B ）, CLP＋UTI group（group C）. Following above method, 30 rats were divided into three groups（n=10） and observed for 7 d survival rate. And also 24 rats were divided into three groups（n=8）, after 24 h of operation, the diaphragm was removed for diaphragm contractile function test, and the content of pro-inflammatory cytokines tumor necrosis factor（TNF）-α, interleukin（IL）-6 oxidative stress indexes of malondialdehyde（MDA）, superoxide dismutase（SOD） were detected. Results 7 d survival in group B was significantly lower than that in group A （20% vs 100% ） （P〈0.05）, and UTI treatment could improve the survival on CLP rats （60% vs 20% ） （P〈0.05）. Diaphragmatic contractility at each frequency of stimulation and maximum tetanic force of the rats in UTI treatment group was significantly higher than that in group B （P〈0.01）. UTI treatment group compared with group B, pro-inflammatory cytokines TNF-α[（6.4±1.8）, （10.4±1.9） ng/g] and IL-6 [（55±8）, （81±9） ng/g] level were significantly decreased （P〈0.05）,the content of MDA [（15.6±3.6）, （21.3±4.5） μmol/g] decreased significantly （P〈0.05） and SOD [（460±57）, （405±32） ng/g] consumption was also significantly reduced （P〈0.05）. Conclusions UTI treatment can improve diaphragmatic contractility in sepsis rats. This may be associated with the drop of TNF-α and IL-6 and the reduction of MDA release and SOD consumption. And also,UTI treatment can significantly improve the survival of the rats with sepsis.

关 键 词：脓毒症 盲肠结扎穿孔 膈肌 乌司他丁 

分 类 号：R459.7[医药卫生—急诊医学]