延迟液体复苏对失血性休克大鼠炎性反应的影响  

Effects of delayed fluid resuscitation on the inflammatory response in hemorrhagic shock rats

作　　者：于帮旭[1] 刘家宁[2] 李堃[1] 孙运波[1] 栾敏[1] 

机构地区：[1]青岛大学医学院附属医院ICU,266003 [2]山东省青岛市立医院口腔科,266011

出　　处：《实用医学杂志》2008年第13期2214-2216,共3页The Journal of Practical Medicine

摘　　要：目的:探讨延迟液体复苏对失血性休克大鼠炎性反应的影响。方法:将40只大鼠随机分为休克后即刻复苏组、休克后延迟30 min复苏组、休克后延迟60 min复苏组、未复苏组。采用Wiggers方法制备可控性失血性休克模型。记录复苏开始即刻(0 min),30、90、150、210、270、330 min平均动脉压水平,并采血测定IL-6、TNF-α和IL-10浓度。结果:液体复苏组复苏开始后各时点平均动脉压水平无明显差异。与未复苏组相比,休克后延迟30、60 min复苏组IL-6、TNF-α浓度明显增加,休克后延迟60 min复苏组IL-10浓度显著降低(P<0.01)。结论:在控制性失血性休克动物模型,延迟液体复苏可使促炎细胞因子生成增加,其增加的程度与延迟复苏时间密切相关。Objective To investigate the effects of delayed fluid resuscitation on the inflammatory response in hemorrhagic shock rats. Methods 40 rats were randomly divided into four lactated Ringer＇s solution resuscitation groups（n = 10）including the immediate resuscitation group, the delayed 30 minutes resuscitation group, the delayed 60 minutes resuscitation group, the unresuscitation group. Volume-controlled hemorrhagic shock rat model was made by Wiggers. Their mean arterial pressures were recorded and blood samples were collected at O, 30, 90, 150, 210, 270, and 330 minutes after hemorrhage for plasma levels of IL-6, IL-10 and TNF-α. Results Mean blood pressure after immediate resuscitation were not different in the delayed resuscitation groups at any time. TNF-α and IL-6 concentrations of the delayed resuscitation 30 and 60 minutes groups were significantly higher than that of the unresuscitation group （P 〈 0.01）, whereas IL-10 concentrations of the delayed resuscitation 60 minutes groups were significantly lower than that of the unresuscitation group （P 〈 0.01）. Conclusion Delayed fluid resuscitation induces increase of proinflammatory cytokine production in hemorrhagic shock models, the increase of which is correlated with the time delayed for resuscitation.

关 键 词：休克 失血性 液体复苏 细胞因子 炎症反应 

分 类 号：R459.7[医药卫生—急诊医学]