高渗氯化钠羟乙基淀粉40溶液对大鼠失血性休克-内毒素二次打击后肺组织的影响  

Effects of Hypertonic Sodium Chloride Hydroxylethyl Starch 40 on Lung Tissues undergoing Hemorrhagic Shock-LPS Attack

作　　者：谭平[1] 苏凤华[1] 宁雪[1] 朱志荣[1] 

机构地区：[1]广州医学院附属肿瘤医院麻醉科,510095

出　　处：《岭南急诊医学杂志》2010年第5期355-357,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省医学科研基金项目(No:A2008298);吴孟超医学科技基金容量治疗专项基金资助项目(No:RGC2007053)

摘　　要：目的:观察用高渗氯化钠羟乙基淀粉40溶液(霍姆注射液,HH40)对失血性休克-内毒素二次打击后肺组织的影响。方法:24只健康雄性Wistar大鼠随机分为4组,每组6只:正常对照组(CON组):不放血不补液;实验组大鼠通过股动脉放血至平均动脉压(MAP)为45 mmHg并维持120 min,然后腹腔一次性注射大肠杆菌脂多糖(LPS)1.5 mg/kg,之后分为:休克组(SH组),不补液复苏;霍姆治疗组(HH40组),用HH40按5 mL/kg静脉输注;高渗盐溶液治疗组(HTS组),用7.5%NaCl按5 mL/kg静脉输注。观察休克2 h末,补液结束即刻、15、30、60、120、180 min时MAP、中心静脉压(CVP)的变化,测定补液结束24 h大鼠肺水含量、肺髓过氧化物酶(MPO)水平,观察肺组织病理学结果。结果:补液结束2、3 h,HH40组MAP、CVP高于HTS组(P<0.05);补液结束24 h,HH40组肺水含量、MPO水平均低于HTS组(P<0.05),病理学结果优于HTS组。结论:用HH40小容量复苏失血性休克-内毒素二次打击大鼠,维持血流动力学稳定时间更长,对肺组织的保护作用优于7.5%高渗盐水。Objective： To investigate the effect of the low volume resuscitation with hypertonic sodium chloride hydroxylethyl starch 40（HH40） on lung injury in rats with hemorrhagic shock-endotoxin attack. Methods： 24 male Wistar rats were randomly divided into 4 groups.The control group（CON,n=6） had no bleeding or infusion, the other 18 rats underwent hemorrhagic shock by withdrawing blood to MAP of 45 mmHg for 120 min,then intraperitoneal with LPS （1.5 mg/kg） was performed. And then the rats were divided into 3 groups： shock group （SH,n=6）with no infusion,HH40 group （HH40,n=6） infusion with 5 mL/kg HH40,i.v and hypertonic saline group （HTS,n=6） infusion with 5 mL/kg 7.5% NaC1, i.v. MAP and CVP were recorded at 2 h after end of hemorrhagic shock and 15, 30,60,120,180 min after infusion. Lung water content and pulmonary myeloperoxidase （MPO） level were assessed at 24 h after infusion and lung histopathology were performed at the same time. Results： MAP and CVP of HH40 group were significantly higher than that of HTS group at 120,180 min after infusion （P〈0.05）. Lung water content and pulmonary MPO level of HH40 group were lower than that of HTS group. The result of lung histopathology of HH40 group was better than HTS group. Conclusion： The use of HH40 for resuscitation of hemorrhagic shock is better than HTS in maintaining stable hemodynamics and alleviating lung injury.

关 键 词：高渗氯化钠羟乙基淀粉40 失血性休克 内毒素 肺组织损伤 高渗盐水 

分 类 号：R459.7[医药卫生—急诊医学]