右美托咪定对失血性休克大鼠多器官损伤的影响

doi:10.3969/j.issn.1002-1949.2018.08.007

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摘要目的研究右美托咪定（Dexmedetomidine, DEX）对失血性休克（hemorrhagic shock，HS）大鼠多器官损伤的影响。方法健康雄性SD大鼠24只，随机分为三组：生理盐水对照组（NS组）、失血性休克模型组（HS组）、右美托咪定治疗组（HS+D组），每组大鼠8只。NS组股静脉给予5 mL/kg生理盐水；HS组建立失血性休克模型；HS+D组复苏前0.5 h腹腔注射右美托咪定100 μg/kg。右颈总动脉置入套管针，连接换能器监测实验期间平均动脉压（MAP）。复苏后 6 h 放血，处死动物，检测血清肿瘤坏死因子-ɑ（TNF-α）、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和氧化亚氮（NO）浓度。检测血氧分压（PaO2）及谷丙转氨酶（ALT）、谷草转氨酶（AST）、尿素氮（BUN）及血肌酐（Cr）浓度，取部分肺、肝、肾组织，检测髓过氧化物酶（MPO）活性。HE染色观察肺、肝、肾组织病理学改变。结果与NS组TNF-α(pg/mL)、IL-6(pg/mL)、IL-8(pg/mL)、NO(μmol/L)（178.87±36.23、368.12±46.96、198.42±46.28、36.45±8.04）比较，HS组血清中TNF-α、IL-6、IL-8、NO（1216.96±97.36、2686.68±178.651、998.01±101.42、546.73±106.22）浓度升高（P<0.01）；与HS组比较，HS+D组TNF-α、IL-6、IL-8、NO (428.5465.48、1656.31±121.57、468.19±88.31、387.34±87.15) 浓度降低（P<0.01）。与NS组PaO2（112±11）mm Hg及ALT(U/L)、AST(U/L)、BUN(μmol/L)、Cr(μmol/L)(62.0±10.2、82.3±11.5、7.38±0.89、42.8±8.2）分别比较，HS组PaO2（81±7）降低，ALT、AST、BUN、Cr(195.2±17.8、203.0±10.3、18.21±1.72、63.9±7.1）浓度升高；与HS组比较，HS+D组PaO2（95±13）mm Hg升高（P<0.01），ALT、AST、BUN、Cr (126.6±11.3、109.4±12.2、10.63±4.78、49.8±6.4)浓度降低（P<0.01）。与NS组肺、肝、肾组织MPO活性(U/g，1.2±0.2、2.5±0.4、1.9±1.7）比较，HS组肺、肝、肾组织MPO活性（5.3±0.6、16.7±1.8、9.2±1.1）升高（P<0.01）；与HS组比较，HS+D组肺、肝、肾组织MPO活性（3.8±0.4、12.8±1.2、6.8±0.8）降低（P<0.01）。与NS组比较，HS组肺、肝、肾组织有明显的病理学损伤；与HS组比较，HS+D组肺、肝、肾组织病理学损伤减轻。结论右美托咪定能减轻失血性休克大鼠肺、肝、肾损伤，其机制与抑制炎性反应有关。

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	夏明珠
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关键词 ：细胞因子, 右美托咪定(DEX）, 失血性休克(HS）, 多器官损伤

基金资助:深圳市科技研发基金（JCYJ20160422142317026）

通讯作者: 李亚丽（1970-），女，硕士，主任医师，E-mail:13613051840@163.com。

作者简介: 夏明珠（1978-），女，主管护师，E-mail:xiamingzhu2010@126.com。

引用本文:

夏明珠，姜远旭，戴中亮，李亚丽. 右美托咪定对失血性休克大鼠多器官损伤的影响[J]. 中国急救医学, 2018, 38(8): 676-680.
Xia Ming-zhu, Jiang Yuan-xu, Dai Zhong-liang, Li Ya-li. Effects of dexmedetomidine on multiple organ injury induced by hemorrhagic shock in rats. Chinese Journal of Critical Care Medicine, 2018, 38(8): 676-680.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.08.007 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I8/676

［1］Gutierrez G, Reines HD, Wulf-Gutierrez ME. Clinical review: hemorrhagic shock［J］. Crit Care, 2004, 8（5）:373-381. ［2］Kholmukhamedov A, Czerny C, Hu J, et al. Minocycline and doxycycline, but not tetracycline, mitigate liver and kidney injury after hemorrhagic shock/resuscitation［J］. Shock, 2014, 42(3):256-263. ［3］Gertler R, Brown HC, Mitchell DH, et al. Dexmedetomidine: a novel sedaiive-analgesic agent［J］. Proc(Bayl Univ Med Cent), 2001, 14(1):13-21. ［4］Zhang J, Wang Z, Wang Y. The effect of dexmedetomidine on inflammatory response of septic rats［J］. BMC Anesthesiol, 2015, 15:68.  ［5］Xiang H, Hu B, Li Z, et al. Dexmedetomidine controls systemic cytokine levels through the cholinergic anti-inflammatory pathway［J］. Inflammation, 2014, 37(5):1763-1770. ［6］Xu L, Bao H, Si Y, et al. Effects of dexmedetomidine on early and late cytokines during polymicrobial sepsis in mice［J］. Inflamm Res, 2013, 62(5):507-514. ［7］Sun Y, Gao Q, Wu N, et al. Protective effects of dexmedetomidine on intestinal ischemia-reperfusion injury［J］. Exp Ther Med, 2015, 10(2):647-652. ［8］Yan X, Cheng X, Zhou L. Dexmedetomidine alleviates lipopolysaccharide-induced lung injury in Wistar rats［J］. Oncotarget, 2017, 8(27):44 410-44 417.  ［9］Kucuk A, Yaylak F, Cavunt-Bayraktar A. The protective effects of dexmedetomidine on hepatic ischemia reperfusion injury［J］. Bratisl Lek Listy, 2014, 115(11):680-684. ［10］Lange M, Van Aken H, Westphal M. Prevention and treatment of major blood loss［J］. N Engl J Med, 2007， 357(12):1260. ［11］Soliman M, Arafah M. Apelin protect against multiple organ injury following hemorrhagic shock and decrease the inflammatory response［J］. Int J Appl Basic Med Res, 2015, 5(3): 195-199. ［12］Yang L, Dong X. Inhibition of Inflammatory Response by Crocin Attenuates Hemorrhagic Shock-Induced Organ Damages in Rats［J］. J Interferon Cytokine Res, 2017, 37(7):295-302. ［13］Tsai JP, Lee CJ, Subeq YM. Calcitriol decreases pro-inflammatory cytokines and protects against severe hemorrhagic shock induced-organ damage in rats［J］. Cytokine, 2016, 83: 262-268. ［14］Admyre C, Axelsson LG, von Stein O, et al. Immunomodulatory oligonucleotides inhibit neutrophil migration by decreasing the surface expression of interleukin-8 and leukotriene B4 receptors［J］. Immunology, 2015, 144(2):206-217. ［15］Kwan J, Horsfield G, Bryant T, et al. IL-6 is a predictive biomarker for stroke associated infection and future mortality in the elderly after an ischemic stroke［J］. Exp Gerontol, 2013, 48(9):960-965.  ［16］McDonald MC, Izumi M, Cuzzocrea S, et al. A novel, potent and selective inhibitor of the activity of inducible nitric oxide synthase (GW274150) reduces the organ injury in hemorrhagic shock［J］. J Physiol Pharmacol, 2002, 53(4 Pt 1):555-569. ［17］Sordi R, Chiazza F, Collino M, et al. Neuronal nitric oxide synthase is involved in vascular hyporeactivity and multiple organ dysfunction associated with hemorrhagic shock［J］. Shock, 2016, 45(5):525-533. ［18］Yuui K, Kudo R, Kasuda S, et al. Ethanol attenuates vasorelaxation via inhibition of inducible nitric oxide synthase in rat artery exposed to interleukin-1β［J］. Hum Exp Toxicol, 2015， 99（5）：417-419.［19］Gamkrelidze M, Intskirveli N, Vardosanidze K, et al. Myocardial dysfunction during septic shock (review)［J］.Georgian Med News, 2014, 237:40-46. ［20］Schl pfer M, Piegeler T, Dull RO, et al. Propofol increases morbidity and mortality in a rat model of sepsis［J］.Crit Care， 2015， 19（1）：45-58.  ［21］Chima RS, Hake PW, Piraino G, et al. Ciglitazone ameliorates lung inflammation by modulating the inhibitor kappaB protein kinase/nuclear factor-kappaB pathway after hemorrhagic shock［J］. Crit Care Med, 2008, 36(10):2849-2857. ［22］Tsung YC, Chung CY, Wan HC, et al. Dimethyl Sulfoxide Attenuates Acute Lung Injury Induced by Hemorrhagic Shock/Resuscitation in Rats［J］. Inflammation, 2017, 40(2):555-565. ［23］Qian C, Ren Y, Xia Y. Sodium tanshinone IIA sulfonate attenuates hemorrhagic shock-induced organ damages by nuclear factor-kappa B pathway［J］. J Surg Res, 2017， 209:145-152. ［24］Wang SL, Duan L, Xia B,et al. Dexmedetomidine preconditioning plays a neuroprotective role and suppresses TLR4/NF-κB pathways model of cerebral ischemia reperfusion［J］. Biomed Pharmacother, 2017， 93:1337-1342.