目的探讨重组人生长激素对失血性休克大鼠胃黏膜损伤的影响。方法18只健康雄性SD大鼠随机均分为对照组、失血性休克组、生长激素治疗组。对照组仅给予麻醉、动静脉插管,不经历失血性休克-复苏过程,插管后4h检测相关指标。失血性休克组经历麻醉,动静脉插管,失血性休克-复苏全过程,生长激素治疗组在休克复苏的同时经颈内静脉推注重组人生长激素(1.5U/kg),该两组于复苏后2h检测相关指标。检测指标包括:使用激光多普勒血流仪测定大鼠胃黏膜血流量(GMBF),采用光镜及透射电镜观察胃黏膜损伤情况。结果失血性休克组GMBF较对照组明显降低(260.4±49.6bpuvs418.6±57.3bpu,P〈0.01),并可见胃黏膜细胞坏死、脱落、溶解,局部溃疡形成。生长激素治疗组GMPF明显提高(368.9±92.2bpuvs260.4±49.6bpu,P〈0.05),与对照组比较无显著性差异(P〉0.05),胃黏膜损伤显著改善。结论重组人生长激素能够通过提高失血性休克大鼠胃黏膜血流量,改善胃黏膜缺血再灌注损伤。
Objective To investigate the protective effect of recombinant human growth hormone (rhGH) on gastric mucosa of rats with hemorrhagic shock. Methods Eighteen healthy male Sprague Dawley (SD) rats were randomly assigned into 3 groups, 6 rats for each group: control group, hemorrhagic shock group and rhGH treated group. The animals in control group were subjected to anaesthesia and intubation, without hemrrhagic shock and resuscitation, and all the parameters were determined 4h after intubation. The animals in hemorrhagic shock group and the rhGH treated group were not only given anaesthesia, intubation for carotid artery and internal jugular vein, but also reproduced as hemorrhagic shockesuscitation model by bleeding from carotid artery and blood transfusion wia internal jugular vein. The animals in rhGH treated group were given rhGH (1.5U/kg) when resuscitation began. In the hemorrhagic shock group and rhGH treated group all the parameters were determined 2h after resuscitation. Gastric mucosal blood flow (GMBF) was determined with laser doppler flowmetry (LDF), and the extent of gastric mucosal injury was assessed with optical microscope and transmission electron microscope (TEM). Results GMBF of the rats in hemorrhagic shock group was significantly lower than that in control group (260. 4±49. 6bpu vs. 418. 6±57. 3bpu, P〈0. 01), and gastric mucosa was injured, presenting cell necrosis, cytolysis and focal ulceration. The GMBF of the rots in rhGH treated group was remarkably richer than that in hemorrhagic shock group (368. 9±92. 2bpu vs, 260. 4±49.6bpu, P〈 0.05), but has no significant difference compared with that in control group ( P〈0. 05). The gastric mucosa injuries in the rots of rhGH treated group were greatly improved. Conclusion The rhGH, through enhancing the GMBF, can ameliorate the gastric mucosal ischemicreperfusion injury in rats with hemorrhagic shock.