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Linger, R.P., Levy, M.M., Carlet, J.M., et al. (2008) Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock. Intensive Care Medicine, 34, 17-60.

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  • 标题: 血必净对脓毒症早期大鼠下丘脑–垂体–肾上腺轴的调节Xuebijing Regulate the Hypothalamic-Pituitary-Adrenal Axis in Septic Rats

    作者: 胡艳玲, 李宏山, 刘淑正

    关键字: 血必净, 脓毒症, 盲肠结扎穿孔, 下丘脑–垂体–肾上腺轴Xuebijing, Sepsis, CLP, Hypothalamic-Pituitary-Adrenal Axis

    期刊名称: 《Advances in Clinical Medicine》, Vol.5 No.1, 2015-03-05

    摘要: 目的:探讨脓毒症早期大鼠血浆中促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)、皮质醇(CORT)水平的变化,明确脓毒症时大鼠下丘脑-垂体-肾上腺(HPA)轴的变化以及血必净对其的调节作用。方法:选用健康雄性SD大鼠40只,随机分为正常对照组(Normal group),假手术组(Sham group),模型组(Sepsis group)和血必净治疗组(XBJ group)四个组,采用改良的盲肠结扎穿孔法(CLP)制作SD大鼠脓毒症模型。观察CLP术后动物的临床表现,术后6小时处死动物,利用放射免疫法检测血浆中促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)、皮质醇(CORT)水平。结果:XBJ组与Sepsis组相比,血浆中CRH、ACTH、CORT水平显著降低(P 0.05)。结论:脓毒症早期大鼠HPA轴处于过度激活的状态,血浆中CRH、ACTH、CORT的水平是升高的;血必净治疗后能够降低血浆中CRH、ACTH和CORT的水平,调节HPA轴的过度激活状态,减轻脓毒症大鼠的感染中毒表现。Objective: To investigate the level changes of corticotropin-releasing hormone (CRH), adren- ocorticotropic hormone (ACTH) and cortisol (CORT) level in plasma in septic rats, without and with the use of Xuebijing injection. The main purpose is to reveal whether Xuebijing can affect the hypothalamus-pituitary-adrenal (HPA) axis in septic rats. Methods: Forty male Sprague- Dawley rats were randomly divided into 4 groups: control group, sham group, saline group (NS group), Xuebijing for treatment group. The septic rat models were challenged by CLP. We observe the clinical manifestation of animal after CLP. We use the radio-immunity method to detect the levels of CRH, ACTH and CORT in plasma. Results: Compared with the Sepsis group, the level of CRH, ACTH and CORT in XBJ group was significantly decreased (P 0.05). Conclusion: In septic rats, the levels of the CRH, ACTH and CORT in plasma were increased, which indicate that HPA axis was more active. Xuebijing can decrease the levels of CRH, ACTH and CORT in plasma, downregulate overactivation of the HPA axis, improves the clinical manifestation.