电刺激迷走神经对内毒素休克大鼠血压的影响

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电刺激迷走神经对内毒素休克大鼠血压的影响

石德光1,杜　欣3,胡　森2,姜小国2,晋　桦2,黎君友2

(1.解放军251医院,河北张家口075000;2.解放军304医院,北京100034;

3.张家口卫生职工中专,河北张家口075000)

摘要:目的　研究电刺激迷走神经对内毒素(L PS)休克大鼠血压的影响。方法　4组雄性W istar大鼠,切断大鼠双侧颈部迷走神经干或做假手术对照,将左侧迷走神经干远端连接刺激电极,于静脉滴注L PS(10m g・kg-1)即刻持续电刺激(5V、2m s、1H z),同时监测平均动脉压(M ABP),并于静脉滴注L PS后1h检测各组血TN F2Α及皮质醇水平。结果　迷走神经电刺激能缓解L PS引起的低血压休克,同时使血TN F2Α水平较L PS组显著降低(105.39±21.52)pg m l,较(129.80±26.56)pg m l,P<0.05;迷走神经切断能加快L PS休克的产生,使M ABP 下降50%的时间提前(9.65±0.53)m in比(25.72±3.07)m in,P<0.05,且使血TN F2Α水平显著上升(159.07±21.94)pg m l比(129.80±26.56)pg m l,P<0.01,血皮质醇水平显著下降(34.89±3.14)ng m l比(42.83±

2.88)ng m l,P<0.01。结论　电刺激迷走神经可以改善L PS休克大鼠的低血压,而切断迷走神经可使休克症

状加重,这种现象与迷走神经影响体内炎症介质的合成与皮质激素的分泌有关。

关键词:迷走神经;平均动脉压;肿瘤坏死因子2Α;皮质激素

中图分类号:R322.8 文献标识码:A 文章编号:100524529(2004)1121249203

Effects of Vagus Nerve Electr ica l Sti m ula tion

on L PS-i nduced Hypoten sion i n Ra ts

SH ID e2guang,DU X in,HU Sen,J I AN G X iao2guo,J I N H ua,L I Jun2you

(D ep a rt m en t of Chest S u rg ery,the251st H osp ita l of PL A,Z hangj iakou,H ebei075000,Ch ina)

Abstract:OBJECTIVE To study the effects of vagu s nerve electrical sti m u lati on on the L PS2induced hypo ten si on in rats.M ETHOD S Fo rty W istar rats w ere random ly divided in to4group s.A n i m als w ere sub jected to b ilateral cervical vago tom y,o r a comparab le sham su rgical p rocedu re in w h ich the vagu s nerves w ere iso lated bu t no t tran sected.T he distal end of a vagu s nerve trunk w as p laced acro ss b i po lar electrodes connected to a sti m u lati on modu le and con tro lled by an acqu isiti on system.Sti m u li w ith con stan t vo ltage(5V,2m s,1H z)w ere app lied to the nerve after adm in istrati on of L PS(10m g・kg-1,E.coli O111∶B4,Sigm a),and the m ean arterial b lood p ressu re(M ABP)w as mon ito red.B lood samp les of these rats w ere co llected at1h after L PS adm in istrati on in all group s.TN F2Αand co rtico sterone in serum w ere determ ined.RESUL TS T he electrical sti m u lati on of the efferen t vagu s nerve sign ifican tly decreased the developm en t of L PS2induced hypo ten si on and TN F con ten ts in serum(105.39±21.52vs L PS group129.80±26.56pg m l,P<0.05),and vago tom y sign ifican tly sho rtened the ti m e to developm en t of shock compared w ith sham2operated con tro ls(ti m e to50%drop in M ABP;9.65±

0.53m in vs25.72±3.07m in,P<0.05)and increased TN F and decreased co rtico sterone con ten ts in serum

(159.07±21.94vs129.80±26.56pg m l,P<0.01;34.89±3.14vs42.83±2.88ng m l,P<0.01).

CONCL USI ONS T he electrical sti m u lati on of the efferen t vagu s nerve cou ld sign ifican tly attenuate the develop2 m en t of L PS2induced hypo ten si on.V ago tom y cou ld sign ifican tly sho rten the ti m e to developm en t of shock com2 pared w ith sham2operated con tro ls.T he resu lts suggested that sti m u lati on of efferen t vagu s nerve activity dow n2 regu late system ic TN F p roducti on and the developm en t of shock du ring lethal endo toxem ia.

Key words:V agu s;M ean arterial b lood p ressu re;T umo r necro sis facto r2Α;Co rtico sterone

近年防治内毒素(L PS)引起的脓毒症、脓毒性

收稿日期:2004202215;　修回日期:2004205229

基金项目:全军医学科研“十五”计划课题(01L081)休克甚至多器官功能障碍综合征(M OD S)的研究,主要集中在采用炎症介质的抗体或拮抗剂等方面,但临床实验结果并不理想。最新的研究表明,迷走神经及其递质对过度炎症反应具有调节作用,然而机

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中华医院感染学杂志2004年第14卷第11期