糖皮质激素对脓毒症大鼠肠道功能的保护作用 - 内科急危重症杂志.doc

编辑老师您好:根据修改意见,回答如下: 既往有糖皮质激素治疗脓毒症休克和ARDS的研究,在重症脓毒症休克时,糖皮质激素可以改善循环,增加复苏成功率,在ARDS的中早期,糖皮质激素也可以改善肺顺应性.在肠道屏障保护方面,也有关于药理性营养素,营养支持方式改善肠道屏障功能的相关文献,但是糖皮质激素和脓毒症休克肠道屏障功能之间的关系,目前尚极少有相关研究,我们从糖皮质激素对脓毒症休克液体复苏的支持作用和ARDS的作用机制推测糖皮质可能有类似的保护肠道屏障功能的作用,并做了相关研究.本课题是黎介寿院士肠道屏障相关研究基金,肠道屏障功能和营养支持治疗我科的特色,有相关的研究基础. 糖皮质激素对脓毒症休克大鼠肠道功能的保护作用 The protective effects of Glucocorticoid on protection of intestinal function of septic shock rats 摘要：目的：研究糖皮质激素对脓毒症大鼠肠道功能的保护作用。方法：45只SD大鼠随机分为3组，对照组（n=5）、脓毒症组（n=20）、糖皮质激素组（n=20）。对照组不予任何处理，脓毒症组和糖皮质激素组采用内毒素注射法制作脓毒症模型，糖皮质激素组在复苏第6h时颈外静脉注射氢化可的松6mg/kg。脓毒症组注射等量生理盐水,24h后测定肠平滑肌肌电慢波活动,然后由腹主动脉采血监测血清SOD和MPO含量，取小肠组织匀浆检测SOD和MPO。结果：脓毒症组血清SOD和肠道SOD均明显低于对照组（P0.05),糖皮质激素组血清SOD和肠道SOD明显高于脓毒症组，糖皮质激素组血清SOD明显低于对照组，但肠道SOD与对照组无差异。糖皮质激素组的血清MPO和肠道MPO均明显高于对照组，脓毒症组血清MPO和肠道MPO均明显高于对照组和糖皮质激素组。糖皮质激素组的慢波频率明显高于脓毒症组,和对照组无差异。糖皮质激素组的慢波振幅明显高于脓毒症组，但低于对照组。结论：糖皮质激素具有降低氧化应激反应，恢复SOD活性，保护肠道屏障功能的作用。 关键词：糖皮质激素；脓毒症；大鼠；肠道屏障 [Abstract] Objective：To study the effects of Glucocorticoid on protection of intestinal function of septic shock rats. Methods：45 SD rats were divided into three groups randomly, sham group( n=5),sepsis group(n=20) and Glucocorticoid group(n=20). Sham group injected nothing. Sepsis model of rats was replicated by intravenous administration of LPS in Sepsis group and Glucocorticoid group. In Glucocorticoid group, the animals were intravenous inject hydrocortisone of 6mg/kg, and sepsis group received an injection of same amount of saline. Plasma SOD and MPO level were detected at 24h. Then the rats in each group were killed. The intestinal tissue of 4cm was taken. The level of superoxide dismutase(SOD) and myeloperoxidase(MPO) were measured. Results: Plasma and intestinal SOD level in sepsis group were significantly lower than those in sham group. Plasma and intestinal SOD level in Glucocorticoid group were significantly higher than those in sepsis group. Plasma SOD level in Glucocorticoid group was obviously lower than that in sham group. However, intestinal SOD level between Glucocorti