活血中药对大鼠脓毒症早期循环及活化蛋白C的影响  

Effects of blood circulation medicine on early stage circulation and activated protein C in septic rats

作　　者：吕杰[1] 杨劲松[1] 安友仲[1] 刘方[1] 

机构地区：[1]北京大学人民医院SICU,100044

出　　处：《中国医药》2010年第3期212-214,共3页China Medicine

摘　　要：目的观察血必净注射液对大鼠全身性感染（Sepsis）早期循环及活化蛋白C的影响。方法盲肠结扎穿孔术制备脓毒症大鼠模型。清洁级雄性sD大鼠75只按随机数字表法分为假手术组、手术组和血必净组，每组25只，各组按处死时间分为术后2、4、6、8、12h组，每组5只。所有实验动物应用10％水合氯醛4ml／kg腹腔注射进行麻醉，并维持镇静，同时监测平均动脉压，并持续补液。假手术组和手术组术后即开始静脉补充生理盐水，血必净组术后1h内给予血必净注射液，之后补充生理盐水。实验动物在规定的时间点取血后处死。血浆血活化蛋白c（APC）含量用大鼠酶联免疫吸附法检测。结果假手术组平均动脉压有轻微下降，但在正常范围内。手术组和血必净组平均动脉压均下降，并逐渐进入休克状态，第11小时和12小时平均动脉压与假手术组相比差异有统计学意义[第11小时：（58．7±7．0）rainHgVS（91．0±8．2）mm与（58．7±8．3）mmHgVS（91．0±8．2）mmHg；第12小时：（48．8±12．9）mmHgVS（83．4±5．5）mmHg与（55．4±4．0）mmHg vs（83．4±5．5）mmHg；P〈0．01或P〈0．05]。但血必净组进入休克时间晚于手术组，且MAP略高于手术组（P〉0．05）。假手术组APC含量没有降低。而手术组的血APC含量在术后2h之后逐渐下降，各时间点均显著低于假手术组（P〈0．01）。血必净组的血APC含量在术后早期逐渐升高，并在术后4h和6h显著高于假手术组和手术组，之后迅速下降，术后12h低于假手术组[（1．800±0．499）μg／LVS（3.418±0．440）μg／L，P〈0．01]，但仍高于手术组（P〈0．01）。结论血必净注射液在脓毒症早期对循环功能有一定的改善。在脓毒症早期使用该药对大鼠蛋白c系统有一定的上调作用，可能是其发挥抗炎及改善微循环作用的机制之一。Objectives To investigate the effects of Xuebijiug injection on early stage circulation and acti- vated protein C in septic rats. Methods Sepsis SD rats were induced by cecal ligation and puncture. Seventy five clean healthy SD rats were randomly divided into three groups： sham operation group, septic model group（ operation group） and Xuebijing treated group. According to the time of sacrifice, the three groups were subdivided into five subgroups： 2, 4, 6, 8 and 12 hours subgroups （5 rats in each subgroup）. All the rats were anesthetized by perito- neal injecting 10% Chloral Hydrate. Mean arterial pressure（MAP） was continuously monitored. Sham operation group and operation group had transfused Sodium Chloride after operation. Xuebijing treated group was transfused Xuebijing injection after operation within 1 hour, and then was transfused Sodium Chloride. Blood samples were obtained at various time points. The levels of plasma activated protein C （APC） were measured by enzyme linked im- munoadsorbent assay. Results The MAP of sham operation group decreased but was still within normal range. The MAP of operation and Xuebijing treated groups all decreased markedly and developed into the state of sepsis shock. The MAP at the time points of 11 h and 12 h were all lower than the MAP of sham operation group significantly（P 〈 0.05 ）. However, the MAP of Xuebijing treated group developed into the state of sepsis shock later than that of op- eration group. The MAP at the time points of 11 h and 12 h were higher than operation group but without significance （P 〉 0.05）. APC levels in plasma of sham operation group had no significant change. Compared with sham opera- tion group, APC levels of the operation group decreased significantly （ P 〈 0. 01 ）. The levels of plasma APC of Xue- bijing treated group were higher than sham operation group and operation group significantly （P 〈 0. 05 or P 〈 0.01 ）. However, APC levels in plasma of Xuebijing treated group decreased significantly a

关 键 词：脓毒症 血必净注射液 循环 活化蛋白C 

分 类 号：R631[医药卫生—外科学]