限制性输液复苏孕兔失血性休克对体液因子变化的影响  

Effect of limited volume resuscitation on inflammatory mediators in pregnant rabbits with uncontrolled hemorrhagic shock.

作　　者：龚时鹏[1] 余艳红[1] 陈莉[1] 

机构地区：[1]南方医科大学南方医院妇产科,广州510515

出　　处：《现代妇产科进展》2009年第6期427-430,共4页Progress in Obstetrics and Gynecology

基　　金：2008年国家自然科学基金资助项目(No:30840089)

摘　　要：目的:探讨限制性输液复苏孕兔失血性休克时,机体内皮素(ET)、血管活性肠肽(VIP)的变化规律及对全身炎症反应综合征(SIRS)发生、发展的影响。方法:建立孕兔失血性休克模型,分别用限制性输液和传统输液方法复苏失血性休克孕兔,比较了两组于不同时间点ET、VIP的含量。结果:(1)急性失血后VIP血清浓度明显升高,经输液处理后血清VIP浓度开始下降,限制性输液组下降明显,与传统输液组比较,第3h,4h和8h,差异有统计学意义(P<0.05);(2)急性失血后ET血清浓度明显升高,经输液处理后血清ET浓度开始下降,限制性输液组下降明显,与传统输液组比较,第3h,4h和8h,差异有统计学意义(P<0.05)。结论:休克发生后,参与或加剧机体发病的体液因子ET、VIP循环水平均明显升高,限制性输液能降低循环ET、VIP水平,减少组织损伤和休克恶化程度,有利于机体促炎-抗炎介质平衡,有效阻断了SIRS的发生和发展。Objective：To study the effect of limited volume resuscitation on systemic inflammatory response syndrome（SIRS） by investigating two regulatory peptides（ vasoactive intestinal peptide and endothelin） changes in the models of pregnant rabbits with uncontrolled hemorrhagic shock. Methods：The model of hemorrhagic shock in pregnant rabbit was established. The hemorrhagic shock of pregnant rabbit was resuscitated by adopting two different transfusion means：limited fluid transfusion and aggressive fluid resuscitation. At various time points, the white blood cell count and the concentrations of ET/VIP were compared between the two groups. Results： （ 1 ） Serum concentration of VIP in both groups increased obviously after hemorrhage. VIP decreased in limited fluid transfusion more quickly than traditional transfusion after resuscitation at T3h/T4h/T8h（P 〈0.05 ）. （2）Serum concentration of ET in both groups increased obviously after hemorrhage. ET decreased in limited fluid transfusion more quickly than traditional transfusion group after resuscitation at T3h/T4h/T8h（ P 〈0.05 ）. Conclusion： Compared with aggressive fluid resuscitation,limited volume resuscitation can ameliorate the increase level of VIP and ET after hemorrhagic shock, and promote the balance between pro- and anti-inflammatory mediator, resulting in decreased occurrence of SIRS.

关 键 词：限制性输液 内皮素 血管活性肠肽 系统性炎症反应综合征 疾病模型 动物 休克 出血性 妊娠 动物 兔 

分 类 号：R717.254[医药卫生—妇产科学]