异丙酚预处理对劳力性热射病大鼠肝脏的保护机制  

Protective mechanism of propofol pretreatment on livers in rats with exertional heat stroke

作　　者：纪筠 刘珺 徐余海 陶天柱 叶博 宋青[3] 杨晓明 JI Jun;LIU Jun;XU Yuhai;TAO Tianzhu;YE Bo;SONG Qing;YANG Xiaoming(Department of Anesthesiology,Air Force Medical Center,Beijing 100142,China;不详)

机构地区：[1]空军特色医学中心麻醉科,北京100142 [2]空天医学总体论证研究室 [3]解放军总医院重症医学科,北京100853

出　　处：《空军航空医学》2022年第4期127-131,共5页AVIATION MEDICINE OF AIR FORCE

摘　　要：目的观察劳力性热射病(exertional heat stroke,EHS)大鼠生化指标、凝血功能、细胞因子和肝脏组织中蛋白高迁移率族蛋白Bl(high mobility group Box 1,HMGB1)表达的变化,探讨异丙酚对EHS大鼠肝脏损伤的保护机制。方法48只10周龄SPF级SD雄性大鼠进行6 d的适应性递增负荷跑台训练后随机分为6组:正常对照组(normal control,NC组)、异丙酚+正常对照组(propofol+normal control,PPF-NC组)、热暴露组(heat exposure,HE组)、异丙酚+热暴露组(propofol+heat exposure,PPF-HE组)、劳力性热射病组(exertional heat stroke,EHS组)、异丙酚+劳力性热射病组(propofol+exertional heat stroke,PPF-EHS组),建立EHS模型,异丙酚预处理。观察各组大鼠生化指标[肌酹(creatinine,Cr)、尿素氮(urea nitrogen,BUN)、谷草转氨酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、碱性磷酸酶(alkaline phosphatase,ALP)、肌酸激酶(creatine kinase,CK)]、凝血功能[活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、D-二聚体(D-dimer,D-D)、纤维蛋白原(fibrinogen,Fib)]、细胞因子[白细胞介素-1 B(interleukin-ip,IL-ip)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子a(tumor necrosis factor a,TNF-a)]、血浆和肝脏中HMGB1表达及肝脏病理学变化。结果EHS组和HE组大鼠的生化指标(Cr、BUN、AST,ALT、ALP、CK)、凝血功能(APTT、Fib、D-D、PT)、细胞因子(TNF-a、IL-ip,IL-6)和肝脏组织中蛋白HGMB1表达较NC组均明显增高(P<0.05),且EHS组较HE组更高(P<0.05)。PPF-HE组和PPF-EHS组在异丙酚处理后,各项指标较EHS组和HE组低(P<0.05)。HE组和EHS组可见肝脏细胞出现异常,PPF-HE组和PPF-EHS组肝脏充血明显减轻,结构破坏程度明显降低。结论异丙酚可以显著减轻剧烈运动和热损伤诱导的全身炎症反应、组织缺血损伤以及凝血功能障碍,降低血浆及肝组织中HMGB1浓度,减轻肝脏损伤Objective To observe the variations of biochemical indexes,coagulation function,cytokines and expressions of HGMB1 in liver tissues of rats with exertional heat stroke,and to explore the mechanism by which propofol protects against liver iiijury in EHS rats.Methods Forty-eight SPF SD male rats which were 10 weeks old were randomly divided into six groups after six days of adaptive incremental load treadmill training:normal control(NC)group,propofol+normal control(PPF-NC)group,heat exposure(HE)group,propofol+heat exposure(PPF-HE)group,exertional heat stroke(EHS)group and propofol+exertional heatstroke(PPF-EHS)group.An EHS model was established,followed by pretreatment with propofol.Biochemical indexes,coagulation function,cytokines,HGMB1 in plasma and livers and pathological lesions of livers were observed.Results Biochemical indexes(Cr,BUN,AST,ALT,ALP,CK),coagulation function(APTT,FIB,D-D,PT),cytokines(TNFa,IL-1P,IL-6)and protein expressions of HGMB1(High Mobility Group Box 1)in liver tissue of rats in the EHS group and HE group were significantly higher than those in the NC group(P<0.05),and they were higher in the EHS group than in the HE group(P<0.05),After propofol treatment,the results of the PPF-HE group and PPF-EHS group showed that propofol pretreatment could inhibit various biological indexes compared with the EHS group and HE group(P<0.05).Abnormal liver cells were observed in the HE group and EHS group.Liver congestion and structural damage were significantly reduced in the PPF-HE group and PPF-EHS group after propofol treatment.Conclusion Propofol can significantly reduce the systemic inflammatory response,tissue ischemia injury and coagulation dysfunction induced by intense exercise and heat injury,concentrations of HMGB1 in plasma and liver tissue,liver injury,and prolong survival.

关 键 词：劳力性热射病 异丙酚 高迁移率族蛋白B1 细胞因子 

分 类 号：R821.53[医药卫生—临床医学] R594.12