Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
PLoS One. 2013 Dec 4;8(12):e81795. doi: 10.1371/journal.pone.0081795. eCollection 2013.
Intra-abdominal hypertension (IAH) can damage multiple organ systems, but the explicit impact on the adrenal gland is unclear. To evaluate the effects of intra-abdominal pressure (IAP) on the secretory function of the adrenal glands, we established canine models of IAH. By comparing morphology; hemodynamics; plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations; and the expression of IL-1, IL-6, and TNF-α in adrenal gland tissue from these dogs, we found that hemodynamic instability occurred after IAH and that IAH increased the plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations. Higher IAPs resulted in more significant changes, and the above indicators gradually returned to normal 2 h after decompression. Compared with the sham-operated group, IAH significantly increased IL-1, IL-6, and TNF-α levels in adrenal tissue, with larger increases in the presence of higher IAPs. However, the concentrations of these markers remained higher than those in the sham-operated group despite their decrease after 2 h of decompression. Histopathological examination revealed congestion, red blood cell exudation, and neutrophil infiltration in the adrenal glands when IAP was elevated; these conditions became more significant with more severe IAH. These results suggest that the secretion of adrenal hormones and adrenal gland inflammation are positively correlated with IAP and that abdominal decompression effectively corrects adrenal gland function.
腹腔内高压(IAH)可损害多个器官系统,但对肾上腺的明确影响尚不清楚。为了评估腹内压(IAP)对肾上腺分泌功能的影响,我们建立了犬 IAH 模型。通过比较形态学;血液动力学;血浆皮质醇、醛固酮、肾上腺素和去甲肾上腺素浓度;以及肾上腺组织中 IL-1、IL-6 和 TNF-α 的表达,我们发现 IAH 后发生血液动力学不稳定,并且 IAH 增加了血浆皮质醇、醛固酮、肾上腺素和去甲肾上腺素的浓度。较高的 IAP 导致更显著的变化,减压后 2 小时上述指标逐渐恢复正常。与假手术组相比,IAH 显著增加了肾上腺组织中 IL-1、IL-6 和 TNF-α 的水平,并且随着 IAP 的升高增加更为明显。然而,尽管减压 2 小时后这些标志物的浓度有所下降,但仍高于假手术组。组织病理学检查显示,当 IAP 升高时,肾上腺出现充血、红细胞渗出和中性粒细胞浸润;随着 IAH 加重,这些情况变得更加严重。这些结果表明,肾上腺激素的分泌和肾上腺炎症与 IAP 呈正相关,腹部减压可有效纠正肾上腺功能。