ACM  >> Vol. 5 No. 1 (March 2015)

    Xuebijing Regulate the Hypothalamic-Pituitary-Adrenal Axis in Septic Rats

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胡艳玲,李宏山:唐山市人民医院重症医学科,河北 唐山;
刘淑正:唐山市第二医院重症医学科,河北 唐山

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


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),均高于Normal组和Sham组,且XBJ组大鼠一般情况表现较Sepsis组轻,Normal组和Sham组之间比较无统计学差异(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), but both groups were significantly higher than that in sham group. And the clinical manifestations in the rats of XBJ group were better. There was no significant difference between Normal control and Sham group (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.

胡艳玲, 李宏山, 刘淑正. 血必净对脓毒症早期大鼠下丘脑–垂体–肾上腺轴的调节[J]. 临床医学进展, 2015, 5(1): 7-11.


[1] 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.
[2] De Hinger, R.P., Levy, M.M., Rhodes, A., et al. (2013) Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock. Intensive Care Medicine, 39, 165-228.
[3] Annane, D., Maxime, V., Ibrahim, F., et al. (2006) Diagnosis of adrenal insufficiency in severe sepsis and septic shock. American Journal of Respiratory and Critical Care Medicine, 174, 1319-1326.
[4] De Jong, M.F., Beishuizen, A., Spijkstra, J.J., et al. (2007) Relative adrenal insufficiency: An identifiable entity in nonseptic critically ill patients? Clinical Endocrinology (Oxford), 66, 732-739.
[5] 崔娜, 刘大为, 王郝等 (2007) 严重感染患者下丘脑-垂体-靶腺轴功能的早期改变. 中国危重病急救医学, 19, 332-335.
[6] 朱雪琦, 王蕾, 刘清泉等 (2006) 血必净注射液对脓毒症大鼠肾保护作用的研究. 中国危重病急救医学, 18, 681- 683.
[7] Chaudry, I.H., Wichterman, K.A. and Baue, A.E. (1979) Effect of sepsis on tissue adenine nucleotide levels. Surgery, 85, 205-211.
[8] 曹书华, 王今达 (2002) 血必净对感染性多器官功能障碍综合征大鼠组织及内皮损伤保护作用的研究. 中国危重病急救医学, 14, 489-491.
[9] 张畔, 曹书华, 崔克亮等 (2002) 血必净对多脏器功能障碍综合征单核细胞HLA-DR表达影响的研究. 中国中西医结合急救杂志, 9, 21-23.
[10] Hubbard, W.J., Choudhry, M., Schwacha, M.G., et al. (2005) Cecal ligation and puncture. Shock, 24, 52-57.
[11] Jame, M., O’Brien Jr., M.D., et al. (2007) Sepsis. The American Journal of Medicine, 120, 1012-1022.
[12] 卢中秋 (2007) 关注脓毒症的神经-内分泌-免疫网络调节作用. 世界急危重病医学杂志, 4, 1894-1896.
[13] Gupta, S., Aslakson, E., Brian, M., et al. (2007) Inclusion of the glucocorticoid receptor in a hypothalamic pituitary adrenal axis model reveals bistability. Theoretical Biology and Medical Modelling, 4, 8.