摘要
目的探讨不同剂量6%羟乙基淀粉溶液(hydroxyeth-ylstarch,HES)130/0.4和林格液复苏对失血性休克大鼠急性肺损伤(acute lung injury,ALI)的早期影响及机制。方法24只♂SD大鼠,随机分为4组,每组6只:sham组,林格液组(RS组),33mlHES组(H1组),50mlHES组(H2组)。RS组输注3倍失血量的林格液;H1组、H2组分别输注33、50ml的HES130/0.4和一定量的林格液(林格液的量为3倍最大的放血量减去相应剂量的羟乙基淀粉)。测定休克前(T0),复苏前(T1),复苏后2(T4)、3h(T5)血气分析、CD11b和CD18的表达;观察肺组织超微结构变化。结果与T0比较,PaO2RS组T1、H1组T1～5、H2组T5升高;复苏组PaCO2T1～5降低;除H1组外,各液体复苏组pH于T4、5降低。RS组肺组织超微结构受损;H1组除线粒体结构轻微改变外基本正常;H2组核周间隙轻度扩张,粗面内质网轻度扩张,有脱颗粒。各液体复苏组于T1、T4、T5CD11b和CD18的表达增强;与RS组比较,H1、H2组于T4、T5CD11b和CD18的表达降低;与H1组比较,H2组于T4、T5CD11b和CD18的表达增强。结论6%HES130/0.433ml·kg-1复合一定量的林格液复苏可减轻失血性休克大鼠早期肺炎性损伤,其机制与抑制外周血白细胞CDllb和CD18的表达有关。
Aim To investigate the effects of 6% hydroxyethyl starch 130/0.4 （6% HES 130/0. 4） and Ringer＇s solution resuscitation on early lung injury in hemorrhagic shock rats and its mechanisms. Methods Twenty-four male SD rats were divided into 4 groups：sham,Ringer＇s solution（RS）,two HES groups （H1,H2）. Group H1,H2 received HES 33,50 ml· kg-1 and Ringer＇s solutions respectively after 90-minute shock（the dose of Ringer＇s solutions was 3 times as muchas the maximum shed blood volume minus the dose of HES）. Blood samples were taken from artery for blood analysis and the expression of CD11b/CD18 at T0,T1,T4,T5. The lungs were removed for ultrastructure examination. Results PaO2 increased in group H1 at T1～5 and group H2 at T5 as compared with T0. PaCO2 decreased in all the resusitation groups. The ultrastructure was basically normal except that the mito-chondria changed slightly in group H1. In group H2, the perinuclear space was dilated slightly and the rough endoplasmic reticulum expanded slightly,and the degranulation was observed. Compared with group RS,the expressions of CD11b and CD18 decreased at T4,T5;compared with group H1,the expressions of CD11b and CD18 in group H2 increased. Conclusions Treatment with 6% HES（130/0. 4）33 ml·kg-1 and Ringer＇s solution can attenuate hemorrhagic shock,and the resuscitation reduces lung injury through inhibition of ex-pressions of CD11b and CD18.
出处
《中国药理学通报》
CAS
CSCD
北大核心
2010年第1期99-103,共5页
Chinese Pharmacological Bulletin
基金
河北省普通高等学校强势特色学科经费资助项目(No2005-52)
河北省卫生厅课题资助项目(No05296)
关键词
羟乙基淀粉
液体复苏
休克
失血性
呼吸窘迫综合征
成人
中性粒细胞
hydroxyethyl starch fluid resuscitation hemorrhagic shock respiratory distress syndrome adult neutrophils
