Page 68 - 2019年1月第30卷第2期

内毒素亲和吸附剂SPV对失血性休克模型大鼠肠壁通透性与细

菌移位的影响 Δ

刘 海（唐山市开滦总医院麻醉科，河北 唐山 063000）
＊
中图分类号 R441.9；R965 文献标志码 A 文章编号 1001-0408（2019）02-0207-05
DOI 10.6039/j.issn.1001-0408.2019.02.13

摘 要 目的：观察内毒素亲和吸附剂SPV对失血性休克模型大鼠肠壁通透性与细菌移位的影响。方法：将85只雄性SD大鼠随
机分为正常组（5只）、休克组（每时间点各5只，共20只）以及SPV低、中、高剂量组（将蒙脱石散0.3 g、硫酸多黏菌素B 0.5 mg、维
生素B6 5 mg溶于生理盐水中制成总体积为5 mL的SPV溶液，即为低剂量；中、高剂量药物成分是低剂量的2、3倍。各剂量组每
时间点各5只，共60只），各给药组大鼠分别灌胃SPV溶液5、10、15 mL，正常组和休克组大鼠灌胃生理盐水5 mL，均给药1次。末
次给药30 min后，除正常组外其余各组大鼠均通过股动脉插管放血术复制失血性休克模型。于复苏后1、4、8、16 h分别检测各组
大鼠血清中二胺氧化酶（DAO）、内毒素、D-乳酸的活性或含量以及计算肠道细菌移位阳性率。结果：与正常组比较，休克组大鼠
各时间点血清 DAO 活性均显著增强，血清内毒素、D-乳酸的含量以及肠道细菌移位阳性率均显著升高（P＜0.05）。与休克组比
较，SPV各剂量组大鼠血清DAO活性（1～16 h各时间点）均显著减弱，血清内毒素、D-乳酸的含量（1～16 h各时间点）以及肠道细
菌移位阳性率（SPV低剂量组4～16 h各时间点，SPV中、高剂量组1～16 h各时间点）均显著降低（P＜0.05），且SPV中、高剂量组
上述指标（1～16 h 各时间点）均显著低于 SPV 低剂量组（P＜0.05）；而 SPV 中、高剂量组上述指标组间比较差异均无统计学意义
（P＞0.05）。结论：内毒素亲和吸附剂SPV可剂量依赖性地改善失血性休克模型大鼠的肠壁通透性，并抑制细菌移位。这种作用
与其降低血清内毒素、DAO、D-乳酸的活性或含量，下调肠道细菌移位阳性率有关。
关键词 失血性休克；二胺氧化酶；内毒素；D-乳酸；肠壁通透性；细菌移位；大鼠
Effects of Endotoxin Affinity Adsorbent SPV on Intestinal Permeability and Bacterial Translocation in
Hemorrhagic Shock Model Rats
LIU Hai（Dept. of Anesthesiology，Tangshan Kailuan General Hospital，Hebei Tangshan 063000，China）

ABSTRACT OBJECTIVE：To observe the effects of endotoxin affinity adsorbent SPV on intestinal permeability and bacterial
translocation in hemorrhagic shock model rats. METHODS：Totally 85 male SD rats were randomly divided into normal group（5
rats），shock group （each 5 rats at each time point，20 rats in total），SPV low-dose，medium-dose and high-dose groups
（Montmorillonite powder 0.3 g，Polymyxin B sulfate 0.5 mg，Vitamin B6 5 mg dissolved in normal saline to obtain SPV solution 5
mL，as low dose；medium and high dose were 2 or 3 times as high as low dose. Each 5 rats of each group at each time point，60
rats in total）. Administration groups were given SPV solution intragastrically 5，10，15 mL once，respectively；normal group and
shock group were given normal saline 5 mL intragastrically once. Thirty minutes after last medication，other groups received
femoral artery catheterization and bleeding to induce hemorrhagic shock model，except for normal group. The activities or contents
of diamine oxidase（DAO），endotoxin and D-lactic acid，positive rates of intestinal bacterial translocation were detected in each
group at 1，4，8，16 h after recovery. RESULTS：Compared with normal group，the activities of DAO of rats in shock group were
enhanced significantly，and the serum contents of endotoxin and D-lactic acid were increased significantly（P＜0.05）. Compared
with shock group，the activities of DAO were decreased significantly in SPV groups（at each time point during 1-16 h）；the serum
contents of endotoxin and D-lactic acid（at each time point during 1-16 h），positive rates of intestinal bacterial translocation（SPV
low-dose group at each time point during 4-16 h，SPV medium-dose and high-dose groups at each time point during 1-16 h）were
decreased significantly（P＜0.05）. Above indexes in SPV medium-dose and high-dose groups（at each time point during 1-16 h）
were significantly lower than those of SPV low-dose group （P＜0.05）. There was no statistical significance in above indexes
between SPV medium-dose group and high-dose group（P＞0.05）. CONCLUSIONS：The endotoxin affinity adsorbent SPV can
improve the permeability of the intestinal wall and inhibit bacterial translocation in hemorrhagic shock model rats in dose-dependent
manner. The effects of which may be associated with reducing the activities or contents of serum DAO，endotoxin，D-lactic acid，
and down-regulating the positive rate of bacterial translocation.
KEYWORDS Hemorrhagic shock；Diamine oxidase；Endotoxin；D-lactic acid；Intestinal permeability；Bacterial translocation；
Rats

[1]
肠道是人体内最大的贮菌场所和内毒素库 。在正
Δ 基金项目：河北省卫生计生委医学科学研究重点课题计划（No.
ZD20140064） 常生理状态下，肠道黏膜可阻止肠道内的细菌及内毒素
[2]
＊副主任医师，硕士。研究方向：临床麻醉学与危重症。E-mail： 转移至肠循环中 。但肠道对机体缺血反应敏感，当发
172169805@qq.com 生缺血再灌注损伤时，机体应激反应可使上述肠道屏障

中国药房 2019年第30卷第2期 China Pharmacy 2019 Vol. 30 No. 2 ·207 ·