摘要
目的：评价乌司他丁对失血性休克∕复苏（ HS∕R）大鼠急性肺损伤的影响。方法选择SPF级成年SD大鼠15只，体重300～400 g，2～3月龄，采用随机数字表法，将其分为3组（ n＝5）：假手术组（ S组）、HS∕R组和乌司他丁组（ U组）。HS∕R组和U组通过颈动脉放血建立失血性休克大鼠模型，维持60 min后回输自体血和生理盐水行容量复苏。 U组于容量复苏前静脉注射乌司他丁5万U∕kg（1．0 ml），S组和HS∕R组以等容量生理盐水替代。于颈动脉穿刺置入套管针后（T0）、休克后5 min（ T1）、容量复苏前（ T2）、复苏至预定血压5 min（ T3）、容量复苏后30 min（ T4）、1．5 h（ T5）和2．5 h （ T6）时采集0．5 ml动脉血样，采用ELISA法测定血浆白细胞介素-6（ IL-6）和肿瘤坏死因子-α（ TNF-α）浓度。于T0、T2和T6时采集动脉血样0．5 ml行血气分析，记录pH值、PaCO2、HCO－3和BE值，计算氧合指数（ OI＝PaO2∕FiO2）。于T6时取肺组织行病理学评分，另取肺组织，分离细胞核，采用ELISA法测定核转录因子-κB（ NF-κB） p65水平。结果与S组比较， U组和HS∕R组pH值、HCO－3、BE值和OI降低，PaCO2和血浆IL-6和TNF-α浓度、肺组织NF-κB p65水平、病理学损伤评分升高（ P＜0．05）。与HS∕R组比较，U组血浆IL-6和TNF-α浓度、肺组织NF-κB p65水平、病理学损伤评分降低（ P＜0．05），血气分析指标比较差异无统计学意义（ P＞0．05）。结论乌司他丁虽然可减轻HS∕R大鼠肺损伤，但不足以改善肺氧合功能。
Objective To evaluate the effects of ulinastatin on hemorrhagic shock and resuscitation （ HS∕R）-induced acute lung injury in rats. Methods Fifteen SPF adult Sprague-Dawley rats, aged 2-3 months, weighing 300-400 g, were divided into 3 groups （ n=5 each） using a random number table：sham operation group （ group S ） , HS∕R group and ulinastatin group （ group U ） . Carotid arteries were cannulated for blood pressure monitoring and blood-letting. HS∕R was induced by blood-letting and maintained for 1 h, followed by resuscitation with autologous blood transfusion and infusion of normal saline. After cannulation of carotid arteries （ T0 ） , at 5 min after hemorrhagic shock （ T1 ） , before resuscitation （ T2 ） , at 5 min after the expected blood pressure was achieved following resuscitation （ T3 ） , and at 30 min, 1-5 h and 2-5 h after resuscitation （ T4-6 ） , arterial blood samples were collected for determination of interleukin-6 （ IL-6 ） and tumor necrosis factor-α （ TNF-α） concentrations （ by enzyme-linked immunosorbent assay） . Arterial blood samples were collected at T0 , T2 and T6 for blood gas analysis. The pH value, partial pressure of arterial carbon dioxide （ PaCO2 ） , HCO-3 and base excess （ BE） value were recorded, and oxygenation index （ PaO2∕FiO2 ） was calculated. Lungs were removed at T6 , and pulmonary specimens were obtained for examination of pathological changes which were scored, and nucleus was extracted for determination of nuclear factor-kappa B （ NF-κB ） p65 expression by enzyme-linked immunosorbent assay. Results Compared with group S, the pH values, HCO-3 , BE values and OI were significantly decreased, and PaCO2 , plasma IL-6 and TNF-α concentrations, expression of NF-κB p65 in lung tissues, and pathological scores were increased in U and HS∕R groups. Compared with group HS∕R, the plasma concentrations of IL-6 and TNF-α, expression of NF-κB p65 in lung tissues, and pathological scores were significantly decrea
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2015年第5期616-619,共4页
Chinese Journal of Anesthesiology
基金
全军医学科技“十二五”科研面上项目（CWS11J019）
湖北省卫生厅科研基金资助项目（JX5840）
关键词
胰蛋白酶抑制剂
休克
出血性
心肺复苏术
呼吸窘迫综合征
成人
Trypsin inhibitors
Shock,hemorrhagic
Cardiopulmonary resuscitation
Respiratory distress syndrome,adult
