星状神经节阻滞减轻失血性休克后肠淋巴液介导的炎症反应  

Stellate ganglion blockade alleviates post-hemorrhagic shock mesenteric lymph-mediated inflammation

作　　者：杜会博[1] 赵向达 段梦瑾 孙转友 付达达 张璨 张立民[1] 赵自刚[1] 牛春雨 DU Hu-bo;ZHAO Xiang-da;DUAN Meng-jin;SUN Chuan-you;FU DA-da;ZHANG Can;ZHANG Li-min;ZHAO Zi-gang;NIU Chun-yu(Institute of Microcirculation/Basic Medical College of Hebei North University,Zhangjiakou 075000,China;Basic Medi-cal College of Hebei Medical University,Shijiazhuang,050017,China)

机构地区：[1]河北北方学院微循环研究所/基础医学院,河北张家口075000 [2]河北医科大学基础医学院,河北石家庄050017

出　　处：《中国病理生理杂志》2021年第12期2237-2243,共7页Chinese Journal of Pathophysiology

基　　金：国家自然科学基金资助项目(No.81770492)。

摘　　要：目的:观察星状神经节阻滞(SGB)对失血性休克大鼠血浆和组织炎症介质的作用及静脉输入失血性休克后肠淋巴液(PHSML)对SGB的影响,探讨SGB减轻失血性休克大鼠炎症反应的肠淋巴机制。方法:常规方法建立失血性休克模型,收集正常淋巴液(NML)、PHSML和SGB处理后的PHSML(PHSML-SGB)。雄性大鼠随机均分为假手术组、假手术+SGB组、失血性休克组(shock组)、shock+SGB组及shock+SGB+回输PHSML(shock+SGB+PHSML)组。各组动物液体复苏后3 h或相应时点,留取门静脉血及肠、肺和肾组织,检测炎症因子。同时,检测NML、PHSML和PHSML-SGB中内毒素水平。结果:大鼠急性失血后90 min内,shock、shock+SGB和shock+SGB+PHSML组大鼠的平均动脉血压均代偿性回升,但组间差异无统计学意义。休克提高了血浆脂多糖受体CD14、脂多糖结合蛋白(LBP)、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平,肾CD14、LBP、TNF-α和CXC趋化因子配体1(CXCL1)水平,以及肠CD14、LBP、TNF-α、IL-6和CXCL1水平;SGB降低了shock组大鼠血浆、肾组织和肠组织TNF-α、CD14、IL-6、LBP和CXCL1水平,以及肺组织CD14和IL-6水平;静脉输入PHSML抑制了SGB降低shock大鼠血浆TNF-α、CD14、IL-6、LBP和CXCL1水平及肾组织CD14和CXCL1水平的作用。此外,SGB降低了PHSML中内毒素水平。结论:SGB可部分减轻失血性休克大鼠的炎症反应。该作用可能与其减少PHSML中的内毒素有关。AIM:To observe the effect of stellate ganglion blockade(SGB)on the inflammatory mediators in serum and tissue of rats with hemorrhagic shock and the effect of intravenous infusion of post-hemorrhagic shock mesenteric lymph(PHSML)on SGB,and to explore the mesenteric lymphatic mechanism of SGB alleviating inflammation in hemorrhagic shock rats.METHODS:The hemorrhagic shock model was established by routine methods,and then the normal mesenteric lymph(NML),PHSML and PHSML after SGB treatment(PHSML-SGB)were collected.Male rats were randomly divided into 5 groups:sham group,sham+SGB group,hemorrhagic shock group(shock group),shock+SGB group and shock+SGB+intravenous infusion of PHSML(shock+SGB+PHSML)group.At 3 h after fluid resuscitation or corresponding time points,portal vein blood,and intestinal,pulmonary and renal tissues were collected to detect inflammatory factors.Meanwhile,the endotoxin level in NML,PHSML and PHSML-SGB was detected.RESULTS:Within 90 min after acute hemorrhage in rats,the mean arterial pressure in shock,shock+SGB and shock+SGB+PHSML groups recovered compensatively,but there was no statistically significant difference among these groups.Shock increased the levels of lipopolysaccharide receptor CD14,lipopolysaccharide-binding protein(LBP),tumor necrosis factor-α(TNF-α)and interleukin 6(IL-6)in plasma,the levels of CD14,LBP,TNF-αand C-X-C motif chemokine ligand 1(CXCL1)in renal tissue,and the levels of CD14,LBP,TNF-α,IL-6 and CXCL1 in intestinal tissue.Treatment with SGB decreased the levels of CD14,LBP,TNF-α,IL-6 and CXCL1 in plasma,renal tissue and intestinal tissue,and the levels of CD14 and IL-6 in pulmonary tissue.Intravenous infusion of PHSML inhibited the beneficial effect of SGB decreasing the levels of CD14,LBP,TNF-α,IL-6 and CXCL1 in plasma and the levels of CD14 and CXCL1 in renal tissue.In addition,SGB treatment reduced the endotoxin level of PHSML.CONCLUSION:Treatment with SGB partially alleviates the inflammatory response in rats with hemorrhagic shock,which may be related to th

关 键 词：星状神经节阻滞 失血性休克 肠淋巴液 炎症 内毒素 

分 类 号：R364.1[医药卫生—病理学] R363.2[医药卫生—基础医学]