Effects Of Hypertonic Solution On Intestinal Mucosal Microcirculation Blood Flow And Nuclear Factor-Kappa B In Hemorrhagic Shock Rats

Objective:TO st'Udy the mechanism of hypertonic solution treating hemorrhagicshock,the changes of intestinal mucosal microcircuIation blood flow(MMBF) andintestinal nuclear factor-kappa B of Sprague-Dawley rats with hemorrhagic shock areobserved before and after hypertonic sodium chloride hydrox}'ethyl starch 40injection ichsion.Mcthods:90 SD rats are divided into the untreated group,thehyPertonic sodiuLm chloride hydrox}yeth}11 staxch 40 injection resuscitated group(HSHgroup) and the Lactated fonger's injection resuscitated group(RL group).the rats aregiven celiac anaesthesia with 2.5%thiopental sodium 50mghg,and then shockedthrough bleeding frorn the femoral artery' within l5 minutes.the shock period last 60minutes with a 5.33 kpa mean artery pressure(MAP).42 rats in the untreated group aregiven no tIeatment,24 rats in the HSH group are resuscitated with hypertonic sodiumchloride hydroxyethyl starch 40 injection 6mlilig after shock period.24 rats in RLgroup are infused with Lactated kinger's injection tWifOld hemorrhage. 'fhe intestinalMMBF of the untreated group are examined at these time pointsfpreshock(as thebaseline level),shock start point,30,60,90,120 and l80 minutes afier shock.6 rats arechecked at every point.The HSH and m group are test at 90,l20, l80 and 300minutes after shock, 6 rats are checked at every point too.Intestinal tissue are gatheredfOr pathological examination and NF- K B inununohistochemical staining.The weightof every rat,the does of the dkrug,the volume of hemorrhage when shock stan. thevoluxne of hemorrhage When shock over,blood pressure, the volume of urine and thetime when the MAP reach the peak vaIue are recorded.Results:the small intestinalmucosal microcirculation blood flow(xfS) of untreated group at 6 time pints are:110.66 i 11 .63, 53.37 i 4.64,l7.l7 i 5.5925,78 i 10.77,9.28 i 6.53 and l1 .93 i5.43mv: the large intestinal MMBF of untreated group are: 100.39i 14.2,70.79l3.46,61.67 ?.21,54.72+ 8.21,47.67 ?.92 and 36.87 ?15.34mv, the difference between small and large intestinal MMBF is significant at every time point with P values<0.05 except the baseline level.The small intestinal MMBF of HSH group are 103.22+ 7.96,92.50 ?4.47,86.17+10.34 and 122.33?.30mv;the RL group are 61.89?.41,64.95?2.94,70.00?.46 and 86.50?3.51mv,the difference between two groups is significant at every time point. P values are 0.00000245,0.006059, 0.011055 and 0.010022 .But the large intestinal MMBF of HSH group are: 86.22?16.56,79.00?1.15,88.22?12.56 and 97.78?3.24mv,the RL group are 84.06?2.75,74.72+ 16.75,89.22?.87 and 96.22?ll.12mv.with P value>0.05 at every time point.pathological examination show the structure of intestinal mucosa recovery to baseline after infusion with HSH,while injured intensively after resuscitation with RL. NF- K B immunohistochemical staining show large number of cells express NF- K B after hemorrhage especially after shock, the expression increased when infused with RL ,but become normal when infused with HSH.ConclusionsrHSH is superior to RL on improving intestinal MMBFjt can suppress expression of NF- K B,and protect intestinal mucosa of SD rats effectively.Triis may be the partial mechanism of HSH treating shock and preventing from MODS.