Wang Yan, Song Jian, Liu Yuhong, Li Yaqiang, Liu Zhengxin
Department of Digestion, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China (mainland).
Department of Gastroenterology and Hepatology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China (mainland).
Med Sci Monit. 2016 Oct 3;22:3523-3528. doi: 10.12659/msm.899688.
BACKGROUND The purpose of this study was to determine the effect of mild hypothermia therapy on gastric mucosa after cardiopulmonary resuscitation (CPR) and the underlying mechanism. MATERIAL AND METHODS Ventricular fibrillation was induced in pigs. After CPR, the surviving pigs were divided into mild hypothermia-treated and control groups. The changes in vital signs and hemodynamic parameters were monitored before cardiac arrest and at intervals of 0.5, 1, 2, 4, 6, 12, and 24 h after restoration of spontaneous circulation. Serum IL-6 was determined at the same time, and gastroscopy was performed. The pathologic changes were noted, and the expression of IL-6 was determined by hematoxylin and eosin (HE) staining and immunohistochemistry under light. RESULTS The heart rate, mean arterial blood pressure, and cardiac output in both groups did not differ significantly. The gastric mucosa ulcer index evaluated by gastroscopy 2 h and 24 h after restoration of spontaneous circulation (ROSC) in the mild hypothermic group was lower than that the control group (P<0.05). The inflammatory pathologic score of gastric mucosa in the mild hypothermic group 6-24 h after ROSC was lower than that in the control group (P<0.05). Serum and gastric mucosa IL-6 expression 0.5-4 h and 6, 12, and 24 h after ROSC was lower in the mild hypothermic group than in the control group (P<0.05). CONCLUSIONS Mild hypothermia treatment protects gastric mucosa after ROSC via inhibiting IL-6 production and relieving the inflammatory reaction.
背景 本研究旨在确定亚低温治疗对心肺复苏(CPR)后胃黏膜的影响及其潜在机制。
材料与方法 诱导猪发生心室颤动。心肺复苏后,将存活的猪分为亚低温治疗组和对照组。在心脏骤停前以及自主循环恢复后0.5、1、2、4、6、12和24小时的间隔时间监测生命体征和血流动力学参数。同时测定血清白细胞介素-6(IL-6),并进行胃镜检查。记录病理变化,并通过苏木精-伊红(HE)染色和光镜下免疫组织化学法测定IL-6的表达。
结果 两组的心率、平均动脉血压和心输出量无显著差异。亚低温组自主循环恢复(ROSC)后2小时和24小时通过胃镜评估的胃黏膜溃疡指数低于对照组(P<0.05)。ROSC后6 - 24小时亚低温组胃黏膜的炎症病理评分低于对照组(P<0.05)。ROSC后0.5 - 4小时以及6、12和24小时亚低温组血清和胃黏膜IL-6表达低于对照组(P<0.05)。
结论 亚低温治疗通过抑制IL-6产生和减轻炎症反应来保护ROSC后的胃黏膜。