贺斯-平衡液为稀释剂的急性等容血液稀释对家兔IL-1、TNF-α等细胞因子的影响  

CHANGES OF RABBIT IL-1 AND TNF-α,ETC CYTOKINES IN RESPONSE TO ACUTE NORMOVOLEMIC HEMODILUTION WITH HAES-BALANCED SOLUTION AS DILUTING AGENT

作　　者：欧珊[1,2] 李著华[3] 刘合年[2] 白树荣[2] 林露[2] 周乐顺[2] 

机构地区：[1]第三军医大学基础部神经生物学教研室,重庆400038 [2]成都军区总医院麻醉科,四川成都610083 [3]泸州医学院基础学院病理生理教研室,四川泸州646000

出　　处：《中国应用生理学杂志》2009年第2期260-263,共4页Chinese Journal of Applied Physiology

基　　金：成都军区总医院2003年院管课题(03Y05)

摘　　要：目的:评价贺斯-平衡液为稀释剂的急性等容血液稀释(ANH)对家兔血清IL-1、IL-2、IL-6和TNF-α等细胞因子含量的影响,为临床应用提供理论依据。方法:选择20只健康成年家兔,随机分为两组(n=10):C组为对照组、H组为贺斯组;实验家兔麻醉后行气管切开、高频喷射通气,游离股动脉、股静脉;C组不进行血液稀释;H组在股动脉放血的同时经股静脉输入2倍放血量的稀释液:6%贺斯+复方乳酸钠溶液,晶/胶为2∶1,放血量V=TBV×(Ho-Hf)/Hav,所放血液于放血后60～120 min回输。分别在放血前(T0),放血后30 min(T1)、60 min(T2)、120 min(T3)和24h(T4)取静脉血检测Hb、Hct和血清IL-1、IL-2、IL-6和TNF-α的浓度。结果:H组在ANH后从T1时点开始血清IL-1、IL-2、IL-6和TNF-α均有增加,T3达高峰,T4开始回落;T1、T2、T3和T4时点与C组间比较差别显著(P<0.01);与ANH前自身对照差别显著(P<0.01);C组在各时间点的血清IL-1、IL-2、IL-6和TNF-α含量变化差别不显著。结论:贺斯-平衡液为稀释剂的急性等容血液稀释(ANH)对家兔血清IL-1、IL-2、IL-6和TNF-α等免疫性细胞因子浓度有上调作用;可引起机体强度不大、作用时间较短的良性应激反应,对机体免疫功能有增强作用。To observe effect of acute normovolemic hemodilution（ANH） with HAES-balanced solution as diluting agent on levels of cytokines including IL-I, IL-2, IL-6 and TNF-α in rabbit serum so as to provide theoretical basis for clinical application. Methods： A total of 20 healthy adult rabbits were enrolled in the study and randomly divided into two groups（ 10 rabbits per group）, ie, control group（ Group C） and HAES group（Group H）. Under anesthesia of the rabbits, we performed incision of trachea, high-frequency jet ventilation and liberation of femoral artery and femoral veins. Group C was free from hemodilution. Group H was injected with dilution（2-fold of blood letting volume） via femoral veins during blood letting of the femoral artery. 6% HAES-steril plus compound solution of sodium lactate, with crystal/gel ratio of 2：1, blood letting volume = TBV × （Ho-Hf）/Hav. All blood was transfused back 60- 120 min after blood letting. Venous blood was collected before blood letting （T0） and 30 min （T1）, 60 min （T2）, 120 min （T3） and 24 h（T4） after blood letting to detect Hb and Hct and measure level of IL-1, IL-2, IL-6 and TNF-α in serum. Results： In Group H, levels of IL-1, IL-2, IL-6 and TNF-α in serum were increased from T1 after ANH, reached peak at T3 but showed decrease at T4, with significant difference compared with Group C at T1, T2, T3 and Ta（P 〈 0.01） and significant difference compared with those before ANH（ P 〈 0.01）. In Group C, there was no significant difference upon IL-1, IL-2, IL-6 and TNF-α in serum at different time points. Conclusion： ANH with HAES-balanced solution as diluting agent can up-regulate the levels of cytokines IL-1, IL-2, IL-6 and TNF-α in rabbit serum. In the meantime, ANH may arouse eustress with low intensity and short action time , which exerts effect of enhancing immune function of the organisms.

关 键 词：贺斯 平衡液 血液稀释 细胞因子 

分 类 号：R392[医药卫生—免疫学] R331.1[医药卫生—基础医学]