摘要
目的研究拟胆碱药卡巴胆碱对大鼠烫伤休克期肠内补液时肠道局部炎症反应和肠组织损伤的影响，为烧伤休克胃肠道补液研究提供依据。方法38只雄性Wistar大鼠，采用沸水法（100℃，10s）造成背部35％TBsAⅢ度烫伤。随机分为不复苏组（单烫组，n=8）、葡萄糖-电解质溶液（glucose electrolyte solution）复苏组（GES组，n=10）、卡巴胆碱治疗组（CAR组，n=10）和GES＋卡巴胆碱复苏组（GES／CAR组，n=10）。两液体复苏组大鼠在烫伤后30min将GES经十二指肠造口匀速泵入，按Parkland公式设定补液速率，即烫伤后第一个24h补液总量4ml·1％TBSA^-1·kg^-1，前8h匀速补一半。CAR组和GES／CAR组大鼠在伤后30min将CAR以60μg·kg^-1溶于0．5ml生理盐水中一次注入十二指肠。所有大鼠在烫伤后4h处死，取空肠组织测定一氧化氮合酶（NOS）、一氧化氮（NO）、肿瘤坏死因子-α（TNF-α）含硅和髓过氧化物酶（MPO）活性，同时测定血浆二胺氧化酶（DAO）活性，采用组间方差分析统计比较各组上述指标的差别。结果GES组的肠组织NOS、NO、TNF-α、MPO和血浆DAO水平与单烫组差异无统计学意义；GES／CAR组各指标较GES组均明显降低[NOS（1．276±0．391vs．（1．818±0．436），P〈0．01；NO（0．925±0．402）vs．（1．561±0．379），P〈0．01；TNF-α（0．87±0．13）vs．（1．94±0．47），P〈0．01；MPO（0．465±0．092）vs．（0．832±0．214），P〈0．01；DAO（0．732±0．192）vs．（1．381±0．564）．P〈0．01]，CAR组各指标也较单烫组和GES组明显降低（P〈0．05或P〈0．01）。结论卡巴胆碱能减轻烫伤休克大鼠肠内液体复苏时的肠道局部炎症反应和组织损伤，其作用机制可能与其兴奋胆碱能神经N受体，抑制促炎因子释放的作用有关。
Objective To investigate the effect of carbachol on local gut inflammation during enteral resuscitation of rats with burn shock. Method Thirty-eight Wistar rats were subjected to 35 % TBSA full thickness scald injury, and enteral fluid was infused into animal intestines via dvodenal stomas 30 minutes post burn. The animals were randomly divided into four groups： no resuscitation （Control, n = 8）, enteral resuscitation using either a glucose electrolyte solution （GES, n = 10） or GES plus carbachol （60μg·kg^-1 ,GES/CAR, n = 10）, or carbachol alone （CAR, n = 10）.The volumeof GES infusion was based on the Parkland formula （4 ml·1%TBSA^-1·kg^-1）. All animals were sacrificed 4 hours post burn, and specimens of jejunal tissue were collected to determinethe levels of tumor necrosis factor （TNF）-α, nitric oxide （NO）, nitric oxide synthase （NOS） and myeloperoxidase （MPO）. Serum assays for plasma diamine oxidase （DAO） activities were also performed. Results There were no statistical differences in the intestinal levels of NOS, NO, TNF-α and MPO, and plasma DAO activities, between the GES group and the control group. Compared to the GES group, the GES/CAR group showed significantly lowered levels of intestinal NOS （ 1.276 ± 0.391 vs. 1.818 ± 0.436, P 〈 0.05）, NO （0.925± 0.402 vs. 1.561±0.190, P 〈 0.05, TNF-α （0.87±0.13 vs. 1.94±0.47, P 〈0.01） and MPO （0.465±0.092 vs. 0. 832 ± 0.214, P 〈 0.05）, and reduetion in plasma DAO aetivites （0. 732 ± 0. 192 vs. 1. 381 ±_ 0. 564, P 〈0.05）. The CAR group also showed significantly lowered levels of intestinal NOS, NO, TNF-α and MPO and redueed plasma DAO aetivites, compared to the GES group. Conclusions Theses results suggest that earbaehol significantly inhibits the release of proinflammatory mediator and attenuates local inflammation in gut during enteral fluid resuscitation of rats in rats with burn shock. We postulate that carbaehol may exert its anti-inflammatory effects via the cholinergie anti-inflammatory pathway.
出处
《中华急诊医学杂志》
CAS
CSCD
2008年第9期917-920,共4页
Chinese Journal of Emergency Medicine
基金
全军医药卫生十一五计划专项课题基金资助（062055）
关键词
烧伤
肠内补液
肠
卡巴胆碱
大鼠
Burn
Enteral resuscitation
Intestine
Carbachol
Rats
