The Effects Of Propofol On Stress Response And Immunobalance In Rats With Traumatic-Hemorrhagic Shock And Resuscitation

Objective:A traumatic-hemorrhagic shock and resuscitation model was established in rats to observe the effects of systemic hypoxia-ischemia damage on stress hormone,cytokines and vital organs.At the same time,we investigated the opsonization of propofol on stress response and immunobalance and the protective effects on vital organs,then discussed the possible mechanisms,in order to provide theory evidence for its new clinical use.Method:66 health male Wistar rats were randomly divided into 3 groups as follows: normal control group,traumatic-hemorrhagic shock and resuscitation group and propofol-treated group.There were 6 rats in normal control group,30 rats in traumatic-hemorrhagic shock and resuscitation group and propofol-treated group respectively,which were divided into 5 subgroups according to 30min,60min,120min,180min and 240min after model was established.Rats in normal control group were killed immediately after anaesthesia.After the model was established, propofol was infused in propofol-treated group at the speed of 10mg/kg/h via femoral vein,while equivalent normal saline was infused in traumatic-hemorrhagic shock and resuscitation group.Samples were collected at given timepoints.Plasma concentration of cortisol,norepinephrine,interfrin-γ(IFN-γ) and interleukin-4(IL-4) were measured using enzyme-linked immunosorbent assays,and the IFN-γ/IL-4 ratio were calculated. Histopathological changes of lung and small intestinal were observed using optical microscope and scored.Results:1.Compared with normal control group,the concentration of norepinephrine in plasm decreased in both traumatic-hemorrhagic shock and resuscitation group and propofol-treated group,especially in traumatic-hemorrhagic shock and resuscitation group,and there was significant statistical difference.As time goes by,the concentration of norepinephrine increased gradually in both groups,tending to recover to normal level,and the concentration in traumatic-hemorrhagic shock and resuscitation groups was lower than normal control group and propofol-treated group at corresponding timepoint until the end of the study and there were significant statistical differences.While the concentration in propofol group reached the normal group level at 180min.2.Compared with normal control group,the concentration of cortisol in plasm decreased in both traumatic-hemorrhagic shock and resuscitation group and propofol-treated group(p<0.01),especially in traumatic-hemorrhagic shock and resuscitation group.As time goes by,the concentration of cortisol increased gradually in both groups,tending to recover to normal level,and the concentration in traumatic-hemorrhagic shock and resuscitation group reached to normal level at 240min timepoint,but was lower than propofol-treated group at corresponding timepoint(p<0.01),while the concentration in propofol-treated group reached to the normal control group level at 180min.3.Compared with normal control group,the concentration of interferon-γand interleukin-4 in plasm increased in both traumatic-hemorrhagic shock and resuscitation group and propofol-treated group(p<0.05 or p<0.01).But the degree of increase was more apparent in traumatic-hemorrhagic shock and resuscitation group than in propofol-treated group.The ratio of interferon-γ/interleukin-4 were more higher in propofol-treated group than in traumatic-hemorrhagic shock and resuscitation group,and the statistical difference emerged at the 240min(p<0.01).4.Compared with normal control group,there were remarkable injury in lung and small intestine in both traumatic-hemorrhagic shock and resuscitation group and propofol-treated group.But compared with traumatic-hemorrhagic shock and resuscitation group,the degree of injury was relieved apparently in propofol-treated group,and there was significant statistical difference(p<0.05 or p<0.01).Conclusion:1.Traumatic-hemorrhagic shock and resuscitation could lead to insufficiency of stress response in rats,and reduce the concentrations of norepinephrine and cortisol in plasm.Propofol has the ability of relieveing the insufficiency of stress response effectively resulting from traumatic-hemorrhagic shock and resuscitation.2.The attack of traumatic-hemorrhagic shock and resuscitation could active the immune system of rats,which resulted in the release of INF-γand IL-4 and led to the drift of immunobalance from Th1 toward Th2.Propofol was able to slow down the speed of immunobalance drift and had the property of immunomodulation. 3.Traumatic-hemorrhagic shock and resuscitation could injury lung and small intestine severely.Propofol played a key role in relieveing tissue injury and protecting vital organ.