Emergency Medicine Clinical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China.
Clin Hemorheol Microcirc. 2021;78(2):175-185. doi: 10.3233/CH-211100.
Shenfu injection (SFI) is a traditional Chinese herbal medicine which has been clinically used for treatment of septic shock and cardiac shock. The aim of this study was to clarify effects of SFI on cerebral microcirculation and brain injury after hemorrhagic shock (HS).
Twenty-one domestic male Beijing Landrace pigs were randomly divided into three groups: SFI group (SFI, n = 8), saline group (SA, n = 8) or sham operation group (SO, n = 5). In the SFI group, animals were induced to HS by rapid bleeding to a mean arterial pressure of 40 mmHg within 10 minutes and maintained at 40±3 mmHg for 60 minutes. Volume resuscitation (shed blood and crystalloid) and SFI were given after 1 hour of HS. In the SA group, animals received the same dose of saline instead of SFI. In the SO group, the same surgical procedure was performed but without inducing HS and volume resuscitation. The cerebral microvascular flow index (MFI), nitric oxide synthase (NOS) expression, aquaporin-4 expression, interleukin-6, tumor necrosis factor-α (TNF-α) and ultrastructural of microvascular endothelia were measured.
Compared with the SA group, SFI significantly improved cerebral MFI after HS. SFI up regulated cerebral endothelial NOS expression, but down regulated interleukin-6, TNF-α, inducible NOS and aquaporin-4 expression compared with the SA group. The cerebral microvascular endothelial injury and interstitial edema in the SFI group were lighter than those in the SA group.
Combined application of SFI with volume resuscitation after HS can improve cerebral microcirculation and reduce brain injury.
参附注射液（SFI）是一种传统的中药，已在临床上用于治疗感染性休克和心源性休克。本研究旨在阐明 SFI 对失血性休克（HS）后脑微循环和脑损伤的影响。
21 只雄性国产北京长白猪随机分为 3 组：SFI 组（SFI，n=8）、生理盐水组（SA，n=8）或假手术组（SO，n=5）。在 SFI 组中，动物通过快速出血在 10 分钟内将平均动脉压降低至 40mmHg，并维持在 40±3mmHg 60 分钟。HS 后 1 小时给予容量复苏（失血和晶体液）和 SFI。在 SA 组中，动物给予等量生理盐水代替 SFI。在 SO 组中，进行相同的手术程序，但不诱导 HS 和容量复苏。测量脑微血管血流指数（MFI）、一氧化氮合酶（NOS）表达、水通道蛋白-4 表达、白细胞介素-6、肿瘤坏死因子-α（TNF-α）和微血管内皮的超微结构。
与 SA 组相比，HS 后 SFI 显著改善脑 MFI。SFI 上调脑内皮 NOS 表达，但下调白细胞介素-6、TNF-α、诱导型 NOS 和水通道蛋白-4 表达，与 SA 组相比。SFI 组脑微血管内皮损伤和间质水肿较 SA 组轻。
HS 后联合应用 SFI 和容量复苏可改善脑微循环，减轻脑损伤。
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