摘要
目的:探讨葡萄糖-胰岛素-钾(极化液,GIK)对内毒素休克兔脑氧化损伤的影响。方法:20只新西兰大白兔经静脉注射脂多糖(LPS)建立内毒素休克模型后随机分成内毒素休克组(ES组)和极化液组(GIK组),每组10只。ES组静脉持续输注复方氯化钠注射液;GIK组静脉持续输注极化液(葡萄糖G:200 G/L;胰岛素I:60 U/L;氯化钾K:60 mmol/L),时间6 h。比较两组大白兔各时间点平均动脉压(MAP)、血糖、血清特异性稀纯化酶NSE浓度;左脑皮层氧化指标过氧化氢(H_(2)O_(2))、一氧化氮(NO)、诱导型一氧化氮合酶(iNOS)、丙二醛(MDA)及抗氧化指标超氧化歧化酶(SOD)、总抗氧化能力(T-AOC)水平;右侧皮层脑组织形态。结果:注射LPS后,两组大白兔MAP均降低(P<0.05)。复苏后,MAP逐渐回升,GIK组回升更明显;各时间点血清NSE水平持续升高(P<0.05),血糖呈先升高后降低趋势。与ES组相比,GIK组各时间点MAP升高更明显(P<0.05),血糖更平稳(P<0.05);血清NSE水平、脑组织匀浆中氧化物(H_(2)O_(2)、NO、iNOS、MDA)水平降低(P<0.05);SOD、T-AOC升高(P<0.05)。光镜和电镜下观察显示,ES组和GIK组皮层脑组织神经元和线粒体超微结构破坏明显,但GIK组神经元和线粒体损伤情况均轻于ES组(P<0.05)。结论:GIK可改善内毒素休克兔血流动力学,减轻脑氧化损伤。
Objective:To investigate the effect of Glucose-insulin-potassium(GIK)on hemodynamics and and cerebral oxidative damage in rabbits with endotoxic shock.Methods:20 New Zealand white rabbits were given intravenous injection of LPS to establish endotoxin shock model,followed by equally and randomly divided into ES group and GIK group,10 cases in each group,then intravenous injection of compound sodium chloride and GIK(G:200 g/L,I:60 U/L,K:60 mmol/L)for 6 hours respectively.The mean arterial pressure(MAP),blood glucose and the concentration of serum specific purified enzyme NSE,the concentrations of oxidative indexes(H_(2)O_(2),NO,iNOS,MDA)and antioxidant indexes(SOD,T-AOC),and the morphological changes of right cerebral cortex were compared between the two groups.Results:Compared with the baseline value,MAP decreased significantly after LPS injection(P<0.05),After recovery,MAP gradually rebounded,especially in GIK group,the level of serum NSE increased continuously at each time point(P<0.05),and blood glucose showed a trend of first increase and then decrease.Compared with ES group,after GIK intervention,the MAP increased more significantly at each time point(P<0.05),blood glucose was more stable,serum NSE level and brain tissue homogenate oxide(H_(2)O_(2),NO,iNOS,MDA)levels decreased significantly at each time point(P<0.05),while antioxidant index SOD and T-AOC increased and the difference was statistically significant(P<0.05).The ultrastructural damage of neurons and mitochondria in the cortex of ES group and GIK group was obvious under light microscope and electron microscope,but the damage of neurons and mitochondria in GIK group was lower than that in ES group(P<0.05).Conclusion:GIK can improve hemodynamics and reduce brain oxidative damage in rabbits with endotoxic shock.
作者
李洪琼
王艺铮
万勇
LI Hong-qiong;WANG Yi-zheng;WAN Yong(Department of Anesthesiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Anesthesiology,North Sichuan Medical College,Nanchong 637000,Sichuan,China)
出处
《川北医学院学报》
CAS
2021年第9期1216-1220,共5页
Journal of North Sichuan Medical College
基金
四川省南充市市校科技战略合作专项项目(NSMC20170444)。
