17β-雌二醇对失血性休克家兔肠系膜微循环的改善作用及其机制  

Improvement effect of 17β-estradiol on intestinal mucosal microcirculation in rabbits with hemorrhagic shock and its mechanism

作　　者：杨丽娟[1] 夏雪怡 王振江[1] 吴殿秀 葛贺[1] 张莹[3] 林珈羽 赵鹏 荆琦 张瀚元 刘艳波[1] YANG Lijuan;XIA Xueyi;WANG Zhenjiang;WU Dianxiu;GE He;ZHANG Ying;LIN Jiayu;ZHAO Peng;JING Qi;ZHANG Hanyuan;LIU Yanbo(Functional Laboratory,College of Medical Sciences,Beihua University,Jilin 132013,China;College of Nursing,Beihua University,Jilin 132013,China;Department of Pathology,Affiliated Hospital,Beihua University,Jilin 132013,China)

机构地区：[1]北华大学医学院机能实验室,吉林吉林132013 [2]北华大学护理学院,吉林吉林132013 [3]北华大学附属医院病理科,吉林吉林132013

出　　处：《吉林大学学报（医学版）》2019年第6期1199-1205,I0015,共8页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(813002226);吉林省科技厅自然科学研究计划项目资助课题(182455ZG010347271);吉林省教育厅自然科学研究计划项目资助课题(JJKH20180329KJ,JJKH20170050KJ,JJKH20170053KJ);吉林省卫计委科研基金资助课题(2018J095,2017J085);吉林省吉林市卫生局医疗卫生指导计划项目资助课题(201737131)

摘　　要：目的:观察17β-雌二醇对家兔失血性休克(HS)后肠系膜微循环的改善作用,并探讨相关机制。方法:32只家兔随机分为模型组、生理盐水治疗组、山莨菪碱治疗组和17β-雌二醇预防组,每组8只。采用Chaudry方法制作家兔HS模型,同时记录各组家兔肠系膜微循环变化,光学显微镜下观察各组家兔肠黏膜病理形态表现并采用Chiu氏评分法进行评估,免疫组织化学法检测各组家兔肠黏膜组织中白细胞介素6(IL-6)和CD68巨噬细胞阳性表达率,ELISA法测定各组家兔血清17β-雌二醇、乳酸和IL-6水平。结果:休克治疗2 h后,山莨菪碱治疗组和17β-雌二醇预防组家兔肠系膜血液流态优于生理盐水治疗组(P<0.05)。模型组家兔可见黏膜腺体萎缩,绒毛柱状上皮细胞浆粉染、糜烂;生理盐水治疗组家兔可见肠黏膜上皮部分脱落、断裂,绒毛结构不完整,肠腔内有较多脱落的黏膜组织;山莨菪碱治疗组家兔可见腺体轻度萎缩,绒毛轻度水肿,固有层轻度分离;17β-雌二醇预防组家兔可见肠黏膜腺体大致正常,绒毛、固有层水肿。模型组家兔Chiu氏评分高于其他3组(P<0.05),生理盐水治疗组家兔Chiu氏评分高于17β-雌二醇预防组和山莨菪碱治疗组(P<0.05)。山莨菪碱治疗组和17β-雌二醇预防组家兔肠黏膜组织中IL-6和CD68巨噬细胞阳性表达率均低于生理盐水治疗组和模型组(P<0.05)。17β-雌二醇预防组家兔血清17β-雌二醇水平明显高于其他组(P<0.05),17β-雌二醇预防组家兔血清乳酸和IL-6水平低于其他组(P<0.05),山莨菪碱治疗组和17β-雌二醇预防组家兔血清乳酸和IL-6水平均低于生理盐水治疗组(P<0.05)。结论:17β-雌二醇对HS家兔肠系膜微循环损伤具有改善作用,其机制可能是17β-雌二醇通过减少乳酸生成、降低巨噬细胞浸润和抑制炎症因子IL-6释放来实现的。Objective:To observe the improvement effect of 17β-estradiol on the intestinal mucosal mesenteric microcirculation after hemorrhagic shock(HS)in the rabbits,and to explore the relevant mechanism.Methods:Thirty-two rabbits were randomly divided into model group,saline treatment group,anisodamine treatment group and 17β-estradiol prevention group,and there were 8 rabbits in each group.The HS model was made by Chaudry method,and the changes of intestinal mucosal microcirculation were recorded;the pathomorphology of intestinal mucosa of the rabbits in various groups were observed under microscope and the Chiu’s score was used to evaluate.the positive expression rates of interleukin-6(IL-6)and CD68 macrophages in intestinal mucosa of the rabbits in various groups were detected by immunohistochemistry;the levels of 17β-estradiol,lactic acid and IL-6 in serum of the rabbits in various groups were determined by ELISA method.Results:Two hours after shock treatment,the mesenteric blood flow state of the rabbits in anisodamine treatment group and 17β-estradiol prevention group was better than that in saline treatment group(P<0.05).In model group,the mucosal glands were atrophied,the villous columnar epithelial cells were powdered and corroded;in saline treatment group,the intestinal mucosal epithelium was partially exfoliated and broken,the villi structure was incomplete,and there were many exfoliated mucosal tissues in intestinal cavity;in anisodamine treatment group,the glands were slightly atrophied,the villi were slightly edema,and the lamina propria was slightly separated;in17β-estradiol prevention group,the intestinal mucosal glands were normal,and the villi and the lamina propria were edema.The Chiu’s score of the rabbits in model group was higher than those in other three groups(P<0.05);the Chiu’s score of the rabbits in saline treatment group was higher than those in 17β-estradiol prevention group and anisodamine treatment group(P<0.05).The positive expression rates of IL-6 and CD68 macrophages in intes

关 键 词：17Β-雌二醇 失血性休克 肠黏膜 微循环 家兔 

分 类 号：R605.971[医药卫生—急诊医学]