ObjectiveTo explore the protective effect of sodium acetate Ringer's solution resuscitation combined with lactic acid bacteria on the intestinal mucosal barrier of rats with traumatic hemorrhagic shock.

MethodsThirty SD rats were randomly divided into traumatic hemorrhagic shock without resuscitation group (THS group, n=10), sodium acetate Ringer's solution resuscitation group (AR group, n=10) and sodium acetate Ringer's solution combined with lactic acid bacteria resuscitation group (AL group, n=10).The rats in the AL group were given lactic acid bacteria tablets for 1 week on the basis of normal feeding before the shock model was established (calculated according to the volume area, the rats took 108 mg/kg each time, three times a day).The shock models were established in the THS group, AR group and AL group (average arterial pressure maintained 35±5 mmHg).The AL group and AR group were treated with sodium acetate Ringer's solution for 30 minutes of fluid resuscitation after 60 minutes of shock, and the rats' ileum were observed for 4 hours after resuscitation tissue.THS group was not resuscitated, and ileum tissue was taken 4 hours after shock observation.ELISA was used to detect peripheral blood tumor necrosis factor-α(TNF-α), interleukin(IL)-6, IL-4, and IL-10 concentration.Western blotting method was used to detect the expressions of ileum tissue ZO-1, claudin-1, TLR4, p38 phosphorylation and JNK phosphorylation protein.

ResultsCompared with the THS group, the levels of TNF-α and IL-6 in the peripheral blood in the AL group were decreased, and the levels of IL-4 and IL-10 were increased, and the TNF-α concentration in the AR group was decreased, and the differences of which were statistically significant (P<0.05).Compared with the AR group, the level of TNF-α in peripheral blood in the AL group was decreased (P<0.05).There was no statistical difference in the levels of other cytokines between AR group and AL group (P>0.05).Compared with the THS group, the levels of TLR4, P-P38, and P-JNK in the peripheral blood of rats in the AR group were decreased, and the levels of ZO-1 and Claudin-1 were increased in the AL group, and the differences of which were statistically significant (P<0.05).Compared with the AR group, the levels of ZO-1 and Claudin-1 in the AL group were increased, and the levels of TLR4 and P-JNK were decreased (P<0.05).The histopathological results of the ileum showed that the damage of the ileum tissue in the AL group was less than that in the THS group and AR group.

ConclusionsOn the basis of sodium acetate Ringer's solution to resuscitate traumatic hemorrhagic shock, the application of lactic acid bacteria may further inhibit the expressions of TLR4-p38MAPK/JNK inflammatory signal pathway and reverse the expression imbalance of pro-inflammatory factors and anti-inflammatory factors caused by shock which reduce the trauma intestinal injury in hemorrhagic shock.