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Hypertonic sodium chloride solution resuscitation on hemorrhagic shock in rats organs cell HO-1 mRNA expression and apoptosis in intervention studies

Author: LuYuanQiang
Tutor: HuangWeiDong；CaiXiuJun
School: Zhejiang University
Course: Emergency Medicine
Keywords: Hypertonic sodium chloride solution Recovery Hemorrhagic shock Apoptosis Heme oxygenase-1 Gene Expression
CLC: R459.7
Type: PhD thesis
Year: 2009
Downloads: 136
Quote: 0
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Abstract


Background: Early traumatic hemorrhagic shock is the most common cause of death in systemic microcirculation perfusion dropped sharply, cellular hypoxia and vital organs suffered widespread damage characterized by pathological processes that lead to cell mitochondria microcirculation oxygen supply by loss, but also the cellular level by an acute nutritional and metabolic disorders. Hemorrhagic shock pathophysiology and treatment methods of research in trauma has been a hot issue. Currently, the use of hypertonic saline solution (7.5%) as a resuscitation fluid concept has been recognized and received further elaboration. In recent years, many studies have shown that hypertonic saline solution during hemorrhagic shock resuscitation still has some unique mechanism of action, such as having a good immune conditioning can reduce ischemia / reperfusion induced tissue and organ damage, effective to improve microcirculation, etc., are very worthy of attention. Heme oxygenase -1 (HO-1), is inducible enzyme, in the anti-oxidative stress, reduce ischemia / reperfusion injury, and so has an important role. This study will compare the quantitative detection and sham operation group (Sham group), isotonic saline resuscitation (NS group) and hypertonic sodium chloride solution resuscitation (HTS group) rat heart, liver, lung, kidney and small intestine mucosa and other organs cells HO-1 mRNA expression and cell apoptosis, and thereby investigate the molecular biology of hypertonic sodium chloride solution resuscitation of hemorrhagic shock treatment efficacy and mechanism of action. Methods: In this study, 21 SD rats were made into a severe hemorrhagic shock model, based on different pre-hospital resuscitation fluids were randomly divided into sham operation group (Sham group), hypertonic saline solution resuscitation (HTS group) and other infiltration saline resuscitation (NS group), n = 7, the use of SYBR Green Ⅰ real-time fluorescent quantitative reverse transcription - polymerase chain reaction and flow cytometry FITC-Annexin V / PI staining, quantitative detection of each rat heart , liver, lungs, kidneys and other organs of the intestinal mucosa cells HO-1 mRNA expression and cell apoptosis, and to be compared and analyzed statistically. Results: 1, in which severe hemorrhagic shock rat model, hypertonic saline and isotonic sodium chloride solution recovery can be immediate and effective recovery action and rapid improvements in rats hemodynamic state, and remain stable. 2, NS group and HTS rats after hemorrhagic shock / resuscitation, the organ of the significantly higher incidence rate of apoptosis, in which the intestinal mucosa and lung is particularly evident. Compared with Sham, NS rats, heart, liver, lung, kidney, small intestine and other organs of apoptosis were significantly increased, the differences were statistically significant (P <0.01 or P <0.05). HTS rat lung and intestinal mucosa apoptosis rate was significantly higher, compared with Sham group, the difference was statistically significant (P <0.01). In addition, NS rats heart, lung and intestinal mucosa and other organs of the incidence rate of apoptosis was significantly higher than the HTS rats, the difference was statistically significant (P <0.01). 3, hemorrhagic shock / resuscitation organs cells can induce increased HO-1 mRNA expression. However, compared with Sham group, only the HTS group rat liver, kidney and other organ cells HO-1 mRNA expression was significantly increased, the difference was statistically significant (P = 0.013 both). 4, after hemorrhagic shock and resuscitation, NS group and HTS rats lung cells and intestinal mucosal cells, HO-1 mRNA expression and apoptosis exists between a significant negative correlation. Conclusion: In this severe hemorrhagic shock rats compared with isotonic saline resuscitation, hypertonic sodium chloride solution recovery can be more effective in reducing hemorrhagic shock / resuscitation organs and the incidence of apoptosis induced HO- 1mRNA increased expression may contribute to better protect the body cells and maintain organ function status. Thereby improve the prognosis. Induction of HO-1 gene overexpression and reducing the incidence of apoptosis may be hypertonic sodium chloride solution resuscitation of hemorrhagic shock molecular mechanisms.

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