七氟烷后处理对失血性休克猪肠黏膜AQP8和I-FABP表达的影响  

Effects of post-conditioning with sevoflurane on the expressions of intestinal AQP8 and I-FABP in pigs with hemorrhagic shock

作　　者：陈艳红[1,2] 孙莹杰[1] 张毅男[1] 王丽晶[1] 张铁铮[1] 陈克研[1] 

机构地区：[1]沈阳军区总医院麻醉科,沈阳110016 [2]康平县人民医院麻醉科,辽宁康平110500

出　　处：《解放军医学杂志》2015年第11期911-914,共4页Medical Journal of Chinese People's Liberation Army

基　　金：全军"十二五"医学科研重点项目(BWS12J008)~~

摘　　要：目的观察七氟烷后处理对失血性休克巴马小型猪肠黏膜水通道蛋白8(AQP8)和血清肠脂肪酸结合蛋白(I-FABP)表达的影响,探讨七氟烷后处理对失血性休克引起的肠黏膜屏障损伤的保护作用及可能机制。方法 18只巴马小型猪随机分为对照组(S组)、失血性休克组(HS组)和七氟烷后处理组(Post/Sev组),每组6只。实验动物术前禁食8h,给予丙泊酚3mg/kg实施麻醉。S组麻醉后经股动脉和颈内静脉置管;HS组麻醉置管后建立失血性休克模型;Post/Sev组于麻醉置管建立失血性休克模型成功后给予2%七氟烷吸入30min。各实验组均于麻醉前(T0)及失血性休克后30min(T1)、1h(T2)、1.5h(T3)、2h(T4)、3h(T5)、4h(T6)时间点颈内静脉取血,ELISA法检测血清I-FABP的含量。失血性休克4h后放血处死实验动物,取肠组织制作病理切片,HE染色观察各组病理组织学变化;用干湿比法计算肠组织的含水量;ELISA法检测肠黏膜AQP8的表达水平。结果与S组相比,HS组和Post/Sev组血清I-FABP含量、肠黏膜AQP8表达水平和肠组织含水量均显著升高,差异有统计学意义(P<0.05);与HS组比较,Post/Sev组上述指标明显降低,差异有统计学意义(P<0.05)。光镜观察显示,S组肠黏膜未见明显变化;HS组肠黏膜损伤严重,可见肠黏膜出血、炎细胞浸润、上皮细胞坏死;Post/Sev组肠黏膜损伤明显减轻,仅见黏膜层腺体轻度扩张,上皮层和固有层中度分离,上皮下间隙轻度水肿,少许炎细胞浸润。结论七氟烷后处理可减轻失血性休克引起的肠黏膜屏障损伤,其机制可能与降低I-FABP和AQP8表达、减轻肠黏膜水肿有关。Objective To observe the effects of sevoflurane post-conditioning on the expression of Aquaporin 8（AQP8） and intestinal fatty acid binding protein（I-FABP）, in order to investigate the protective role of sevoflurane post-conditioning on intestinal injury and its underlying mechanism. Methods Eighteen bama miniature pigs were randomly divided into three groups（6 each） using a random number table： control group（S group）, hemorrhagic shock group（HS group）, and sevoflurane post-coditioning group（Post/Sev group）. Experimental animals were fasted for 8 hours before surgery, and propofol 3mg/kg was given via the ear vein. Endotracheal intubation was done when the animal fell asleep. Bloodletting from the femoral artery after anesthesia was done to reproduce hemorrhagic shock. In Post/Sev group, 2% sevoflurane was given by inhalation for 30min（post-conditioning） after successful reproduction of the model. Blood samples were collected prior to anesthesia（T0） and 30min（T1）, 1h（T2）, 1.5h（T3）, 2h（T4）, 3h（T5）, 4h（T6） after hemorrhagic shock. The quantity of blood I-FABP and intestinal AQP8 levels were determined with ELISA. Water content in the intestinal tissue was determined by wet and dry weight method. Histopathological changes in the intestinal tissue were observed with HE staining. Results Compared with the control group, the serum I-FABP content, the expressions of intestinal AQP8, and water content in the intestinal tissue were significantly increased in HS group and Post/Sev（P0.05） group. Compared with HS group, the above indices in Post/Sev group were significantly lower（P0.05）. These results were confirmed by pathological examination. Conclusion Postconditioning with sevoflurane could improve, to some extent, pig＇s intestinal barrier function in hemorrhagic shock, and this effect is likely related with lowering of intestinal AQP8 and I-FABP expression and mucosal edema.

关 键 词：肠黏膜 休克 出血性 七氟烷 脂肪酸结合蛋白质类 水通道蛋白质8 

分 类 号：R605.971[医药卫生—急诊医学]