摘要
目的探讨肠源性脓毒症的发病机制及大黄的干预作用。方法将72只Wistar大鼠随机分为对照组、脓毒症组、大黄组,每组24只。分别在造模后24h、48h、72h、96h,从每组动物中各取6只,在2%戊巴比妥麻醉下开腹,留取空肠,光镜下观察病理改变,并检测门静脉血浆内毒素水平及腔静脉血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平;造模后96h,检测各组大鼠腹腔细菌移位情况。结果光镜下对照组肠腔上皮细胞结构清晰,绒毛排列整齐,未见炎细胞浸润;脓毒症组可见肠黏膜充血、水肿,绒毛上皮细胞变性坏死等,有炎性细胞浸润;大黄组肠黏膜仅有轻度的充血水肿,病理学改变介于脓毒症组与对照组。脓毒症组大鼠造模后不同时间门静脉血浆内毒素水平和腔静脉血浆TNF-α、IL-6水平均明显高于对照组(P均<0.05);大黄组大鼠造模后不同时间门静脉血浆内毒素水平和腔静脉血浆TNF-α、IL-6水平均明显低于脓毒症组(P均<0.05),但仍均明显高于对照组(P均<0.05)。造模96h后,对照组大鼠肝、脾、淋巴结培养基中无菌落生长;脓毒症组细菌移位发生率为83.3%(15/18),大黄组细菌移位发生率为44.4%(8/18),大黄组明显低于脓毒症组(P<0.05)。结论内毒素及炎症因子TNF-α、IL-6在肠源性脓毒症的发病中起重要作用;大黄能抑制机体炎性细胞因子释放,阻止肠道内细菌和内毒素移位,减轻病理改变。
Objective It is to investigate the pathogenesis of intestinal sepsis and the intervention of rhubarb on it. Methods 72 Wistar rats were randomly divided into control group, sepsis group and rhubarb group, with 24 rats in each group. At 24 h, 48 h, 72 h, 96 h after model establishment, 6 rats from each group were selected and given laparotomy under 2% pentobarbital anesthesia, their jejunum was taken to observe pathological changes under light microscope, and the level of plasma endotoxin in portal vein and that of plasma tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the vena cava were detected. At 96 h after model establishment, the bacterial translocation of the peritoneal cavity of each group was detected. Results Under light microscope, the structure of intestinal epithelial cells in the control group was clear, the villi were arranged neatly, and no inflammatory cell infiltration was observed;there was intestinal mucosa congestion, edema, degeneration and necrosis of villus epithelial cells, inflammatory cell infiltration In the sepsis group, and there was only mild hyperemia and edema in the mucosa, and the pathological changes were between the sepsis group and the control group in the rhubarb group. The levels of endotoxin in portal vein and that of TNF-α and IL-6 in vena cava were significantly higher in the sepsis group than those in the control group at different times after modeling(P<0.05), the level of plasma endotoxin in portal vein and that of TNF-α and IL-6 levels in vena cava were significantly lower than those in the sepsis group(P<0.05), but they were still significantly higher than those in the control group(P<0.05). After 96 hours of modeling, no bacterial colony gowth was found in the cluture medium of liver, spleen and lymph node of the rats in the control group;the incidence of bacterial translocation in the sepsis group was 83.3%(15/18), and the incidence of bacterial translocation in the rhubarb group was 44.4%(8/18), the incidence in the rhubarb group was significantly lower than that in the sepsis group(P<0.05). Conclusion Endotoxin and inflammatory factors TNF-α and IL-6 play an important role in the pathogenesis of intestinal sepsis. Rhubarb can inhibit the release of inflammatory cytokines in the body, prevent the transfer of bacteria and endotoxin in the intestinal tract, and alleviate pathological changes.
作者
李爱军
苗进昌
王鑫
刘延杰
LI Aijun;MIAO Jinchang;WANG Xin;LIU Yanjie(Handan Central Hospital, Handan 056001, Hebei, China;The Seventh Hospital of Handan City, Handan 056001, Hebei, China)
出处
《现代中西医结合杂志》
CAS
2019年第31期3434-3438,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
邯郸市科学技术研究和发展计划项目(1723208069-2)
