摘要
目的:观察不同初始补液速率对内毒素休克猪肺损伤的影响。方法:健康巴马香猪24头,采用静脉注射内毒素(LPS,20μg/kg)建立内毒素休克模型后,随机分为4组:内毒素休克组、慢速补液组(10ml/kg/h)、中速补液组(30ml/kg/h)和快速补液组(120ml/kg/h),每组各6头。观察注射LPS前、液体复苏即刻、复苏3h、复苏6h、复苏9h和复苏12h血乳酸水平变化。复苏12h后处死动物,取肺组织,HE染色观察肺组织病理变化,免疫荧光法观察肺组织髓过氧化物酶(MPO)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平,Tunnel染色观察肺细胞凋亡情况。结果:与内毒素休克组相比,各补液组乳酸值、肺组织MPO、IL-6、IL-1β及细胞凋亡指数均显著降低(P<0.05);在各补液组中,中速补液组和快速补液组血乳酸值显著低于慢速补液组(P<0.05),乳酸清除率显著高于慢速补液组(P<0.05);中速补液组肺组织MPO、IL-6、IL-1β及细胞凋亡指数较其余两补液组明显降低(P<0.05)。结论:初始进行液体复苏能够降低内毒素休克时肺损伤程度,但不同复苏策略减轻肺损伤的程度不同,中速补液减轻肺损伤效果最佳。
Objective:To observe the effect of different initial resuscitation rate on lung injury in endotoxemic shock swines.Method:After endotoxin shock model was established by intravenous injection of endotoxin(LPS,20ug/kg)in 24 healthy Bama miniature swines,they were randomly divided into 4 groups:endotoxin shock group,slow rehydration group(10ml/kg/h),medium rehydration group(30ml/kg/h)and fast rehydration group(120ml/kg/h).Changes of blood lactic acid level were observed before LPS injection,immediately after fluid resuscitation,3h after resuscitation,6h after resuscitation,9h after resuscitation and 12h after resuscitation.After 12 h of resuscitation,the animals were sacrificed,lung tissues were taken and the pathological changes of lung tissues were observed by HE staining.Lung tissue myeloperoxidase(MPO),interleukin-6(IL-6)and interleukin-1β(IL-1β)were observed by immunofluorescence method.Lung cell apoptosis was observed by Tunnel staining.Results:Compared with the endotoxin shock group,the lactic acid value,lung tissue MPO,IL-6,IL-1β,and apoptosis index were significantly reduced in fluid supplement groups(P<0.05).In fluid supplementation groups,the blood lactic acid value of the medium speed fluid supplementation group and the fast speed fluid supplementation group was significantly lower than that of the slow speed fluid supplementation group(P<0.05),and the lactic acid clearance rate was significantly higher than that of the slow speed fluid supplementation group(P<0.05).MPO,IL-6,IL-1βand apoptosis index of lung tissue in the medium speed fluid infusion group were significantly lower than those in the other two groups(P<0.05).Conclusion:Fluid resuscitation can reduce lung injury in endotoxemic shock,but different strategies have different impact and medium speed fluid is more efficiency in reducing lung injury.
作者
赵玉乾
胡波
李琪
史川川
项辉
李建国
ZHAO Yu-qian;HU Bo;LI Qi;SHI Chuan-Chuan;XIANG Hui;LI Jian-guo(Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China)
出处
《微循环学杂志》
2020年第1期17-23,共7页
Chinese Journal of Microcirculation
基金
国家自然科学基金(8157946)。
关键词
补液速率
液体复苏
内毒素休克
肺损伤
Fluid resuscitation rate
Fluid infusion
Endotoxemic shock
Lung injury
