摘要
目的:研究高渗盐水(HS)对创伤失血性休克所致急性肺损伤(ALI)的作用及其机制。方法:新西兰白兔30只随机分为3组,假手术组(Sham组)、生理盐水处理组(NS组)、高渗盐水治疗组(HS组)。NS组和HS组复制创伤失血性休克动物模型,分别以NS、HS(75g/L氯化钠,4ml/kg)复苏。观察肺组织的病理改变;双抗体夹心ELISA法测定休克前、休克末、复苏后2、4h血清TNFα、IL-6、IL-10和sICAM-1的浓度;逆转录-聚合酶链反应(RT-PCR)检测肺组织各细胞因子及ICAM-1的mRNA表达水平。结果:与NS组比较,HS组复苏后4h肺组织的病理学损伤显著减轻,TNFα、IL-6、ICAM-1血清浓度及肺组织mRNA表达水平均有不同程度下降(P<0.05),而IL-10的浓度及mRNA水平明显增高(P<0.01)。结论:HS治疗可抑制创伤失血性休克时促炎细胞因子及黏附分子的表达,同时增加抗炎细胞因子的释放与表达,减轻肺部的炎症反应,从而发挥对ALI的保护作用。
Objective：To investigate the effects of hypertonic saline on acute lung injury（ALI） induced by traumatic hemorrhagic shock and its mechanism. Methods：Thirty New Zealand white rabbits were randomly divided into three groups： control group （Sham group）, normal saline group （NS group） and hypertonic saline group （HS group）. Traumatic hemorrhagic shock animal model was established followed by resuscitation with NS or HS （75 g/L sodium chloride,4 ml/kg）. Pathologic changes of pulmonary tissues were observed under microscope. Serum concentrations of proinflammatory cytokines such as tumor necrosis factor-α （TNF-α）,interleukin-6 （IL-6）,and antiinflammtory cytokine such as interleukin-10 （IL-10）, as well as soluble intercellular adhesion molecule-1 （sICAM-1） were determined by sandwich enzyme-linked immunosorbent assay （ELISA） in pre-shock,post-shock,2 and 4 hours after fluid resuscitation. The mRNA levels of cytokines and ICAM-1 in pulmonary tissues were measured with reverse transcription-polymerase chain reaction （RT-PCR）. Results： Compared with NS group, pathologic changes of pulmonary tissues significantly attenuated, serum concentrations and mRNA levels of TNFα, IL-6 and ICAM-1 reduced in different degrees（P〈0. 05） ,whereas the release and expression of IL-10 markedly increased（P〈0. 01） in 4 hours after fluid resuscitation in HS group. Conclusion： HS therapy can protect rabbits with traumatic hemorrhagic shock from ALl by inhibiting the synthesis, secretion and expression of proinflammatory cytokines and adhesion molecule, and upregulating the release and expression of anti-inflammtory cytokines, and thus relieving pulmonary inflammation.
出处
《内科急危重症杂志》
2007年第1期24-27,共4页
Journal of Critical Care In Internal Medicine
关键词
高渗盐水
创伤失血性休克
细胞因子
黏附分子
急性肺损伤
Hypertonic saline Traumatic hemorrhagic shock Cytokine Adhesion molecule Acute lung injury
