延迟复苏对40%血容量失血犬外周血淋巴细胞功能影响的初步研究  

Effects of Delayed Resuscitation on Immune Status of Dogs in Hemorrhagic Shock

作　　者：王瑞晨[1] 杨红明[1] 胡森[1] 董宁[1] 侯经元[1] 李琳[1] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所,北京100037

出　　处：《临床军医杂志》2009年第2期174-177,共4页Clinical Journal of Medical Officers

基　　金：首都医学发展科研基金(2002-1010)资助项目

摘　　要：目的观察延迟复苏对犬40%血容量失血后淋巴细胞免疫功能的影响。方法雄性Beagle犬8只,按全身血容量的40%半小时放血完毕。伤后24 h开始液体复苏,伤后第二个24 h按失血量的3倍给予乳酸林格液,48h后给予生理需要量。记录动物72 h死亡率,采集伤前及伤后1、4、24、48、72 h的外周静脉血,检测T淋巴细胞凋亡率、增殖能力、CD3+/CD4+和CD3+/CD8+T淋巴细胞的百分率,并计算其比值。结果与伤前比较,失血性休克后1、4、24、48、72 h各点T淋巴细胞凋亡率均较伤前显著降低(均P<0.05);伤后24 h和72 h淋巴细胞增殖能力较伤前降低,但24 h和72 h之间无显著差异。伤后CD4+T细胞比例无显著变化,CD8+T细胞比例较伤前显著增加。CD4+/CD8+T淋巴细胞比例于伤后1 h开始下降,伤后4、24、48、72 h均比伤前显著降低(P<0.05);但复苏前后无显著差别。结论犬40%血容量失血导致淋巴细胞免疫功能持续抑制,延迟复苏并不能有效改善免疫功能。Objective To investigate the effects of delayed resuscitation on immune function of lymphocytes in dogs subjected to 40% of blood volume loss. Methods Eight dogs were subjected to a loss of 40% hemorrhagic volume from the right common carotid artery. The peripheral venous blood samples were collected at pre-hemorrhage and 1-, 4-, 24-, 48-, and 72-hour later alter hemorrhage for the analysis of lymphocyte apoptosis rate, lymphocyte prohferation ability, percentage of CD3^＋/CD4^＋ and CD3^＋ / CD8^＋, and ratio of CD4^＋/CD8 ^＋ T cells. Results Compared with that in pre-hemorrhage, the lymphocyte apoptosis rate was decreased dramatically at 1 -, 4-, 24-, 48-and 72-hour after hemorrhage shock （ P 〈 0.05 ）. The lymphocytic proliferation ability was also decreased. The percentage of CD8^＋ T lymphocytes were obviously increased after hemorrhage shock, the ratio of CD4^＋/CD8^＋ T cells were decreased dramatically, and there was no significant change between preemorrhage and after resuscitation. Conclusion Immune response of dogs subjected to 40 % of blood volume loss is depressed. Delayed resuscitation brings about neither significant adverse nor beneficial effects on immune function in the dog model.

关 键 词：失血性休克 延迟复苏 免疫功能 

分 类 号：R364.14[医药卫生—病理学]