| Objective: The study is to evaluate the effects of SPV ( Smecta, Polymyxin B, Vitamin B6) on the protection of intestinal mucosal structure and on the prevention enterogenous endotoxin from blood circulation, through examination of the serum diamines oxidase (DAO), endotoxin (ET) and small intestine pathological morphology changes in severe traumatic hemorrhagic shock rats.Methods: 1. 85 healthy male SD rats, with weighs 300 + 20g and SPF (no specific pathogens) , were randomly divided into normal control group (GroupⅠ, n = 5), shock group (GroupⅡ, n = 40) and SPV intervention group (Group -Ⅲ, n = 40). The latter two groups were subdivided into 5 subgroups (n=8) according to the different time points of 1h, 2h, 4h, 8h,16h after the traumatic hemorrhagic shock was established.2. The rat model of severe traumatic hemorrhgic shock was establised with the method of our research institute.3. The morphologic observation of small intestinal mucosa was examined with HE dyeing by light microscope.4. Diamines oxidase expression was detected by colorimetric method.5. Endotoxin expression was detected by photometric method.6. All data were statistically analysed by single factor analysis of variance, with normality inspection test. The results were expressed with of mean±standard deviation (X±S), with P < 0.05 as significant difference ; P < 0.01 as very significant. SPSS17.0 statistical software was applied for statistical calculations.Results: 1. Morphologic observation by HE dyeing: The normal intestinal mucosal villi are the long and phalangeal cytoplasmic processes, with the hight of several times of crysta. There are minimal infiltration of lymphocytes and one or two longitudinal capillary lymphatic tubes in the villus covered with single layer of columnar epithelial cells. However, After shock happened, the number of intestinal villi became less gradually, with the morphological changes of the shorter, thicker, irregularlly shaped or broken villi. There were villi fragments seen inside the intestinal cavity; The epithelial cells were in different sizes, arranged disorderly, and cell degeneration and necrosis were seen. In 2h after shock, there were visible edema and anabrosis of intestinal mucosa with difffuse blood spots, necrosis and ulser. The edema, thickening, breaking and cystic changes were also seen in submucosal and muscular layers. There were less pharthological damages in SPV group than those in shock group.2. DAO: The normal value of serum DAO content is minimal with stable activity. There were gradually increased DAO contents at 1h, 2h, 4h time points in shock group and SPV group. In SPV group the value of DAO was 1/2 less than that of shock group from the beginning of the shock. DAO values were peaked at 8h time point in shock group while in SPV group they went down with the significant difference between the groups (P < 0.01) and among the different time phases in each group(P < 0.01).3. Endotoxin: The normal walue of serum endotoxin was similar between human and rats ( mean=8.991), examined by endotoxin detector. There was gradually increase in serum endotoxin contents in shock group,with the hightest value of 50 times of controls. While in SPV group the DAO value was increased to 34 times of controls at 1h time point but 1/2 of that in shock group. There were significant decrease in DAO values during shock process and reached to normal level at 16h time phase in SPV group(P < 0.01, between shock and SPV groups). There were also significant difference among the different time points in each group (P < 0.01).Conclusion: 1. Endotoxin, DAO and pathological are the sensitive indexes in evaluation of small intestine permeability.2. There are positive correlation between morphological changes and serum endotoxin, DAO during severe traumatic hemorrhagic shock in rats. The longer the shock lasts, the worse the pathological changes of the intestine mocosa and the higher contents of endotoxin and DAO.3. There are significant effects of SPV mixture on deduction of serum endotoxin, DAO and protection and improvement of intestinal function and structure in rats with severe traumatic hemorrhagic shock. |
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