高渗盐己酮可可碱复苏对失血性休克大鼠肺部炎症反应的影响  

Effects of hypertonic saline and pentoxifylline on pulmonary inflammation in rats with hemorrhagic shock

作　　者：刘玉[1,2] 唐季春[1,2] 张焰[1] 曾因明[2] 

机构地区：[1]苏州大学附属第四人民医院麻醉科,江苏省无锡214062 [2]江苏省麻醉学重点实验室

出　　处：《中华急诊医学杂志》2010年第10期1055-1058,共4页Chinese Journal of Emergency Medicine

摘　　要：目的 探讨HSPTX（7.5%氯化钠＋己酮可可碱）对失血性休克大鼠肺损伤的影响.方法 24只雄性SD大鼠随机（随机数字法）分为3组：假失血性休克（Sham）组,仅接受动静脉插管操作,不放血及复苏;大容量乳酸钠林格氏液（RL）复苏组,接受32 mL/kg RL;小容量高张液（7.5%氯化钠）＋PTX复苏组,接受4 mL/kg 7.5%NaCL＋25 mg/kg PTX,每组8只.测定各组动脉血氧分压（PaO2）,pH值,二氧化碳分压（PaCO2）,肺湿/干质量比值,测定血清丙二醛（MDA）含量以及超氧化物歧化酶（SOD）活性;检测支气管肺泡灌洗液（BALF）中性粒细胞比例及肺通透性指数,采用ELISA法测定灌洗液上清中肿瘤坏死因子-α（TNF-α）、白细胞介素1-β（IL-1β）含量.结果 与RL组相比,HSPTX组PaO2和pH值升高、PaCO2降低（P＜0.01）,HSPTX组大鼠肺湿/干质量（W/D）及支气管肺泡灌洗液中上清中TNF-α、IL-1β含量均低于RL组（P＜0.01）.结论 HSPTX复苏可减少失血性休克大鼠炎性细胞因子的表达,减轻由失血性休克诱发的急性肺损伤.Objective To explore the effects of 7.5% hypertonic saline （HS） and pentoxifylline （PTX） on the pulmonary inflammation in rats with hemorrhagic shock. Method Controlled hemorrhagic shock in rats was induced to 40 mmHg MAP by blood withdrawal and maintained for 60 min. Animals were randomly （random number） divided into 3 groups. In sham shock group （ n = 8）, rats underwent cannulation without exsanquination or resuscitation and served as negative controls. In RL-resuscitated animals group （ n = 8）, rats received 32 mL/kg RL （Ringers＇lactate solution）. In HSPTX group, rats received 4 mL/kg of 7.5% NaCl ＋ 25 mg/kg of PTX.PaO2,pH,PaCO2, lung wet/dry weight ratio （W/D） and lung penetrating index were determined, and the percentages of neutrophil in bronchoalveolar lavage fluid （BALF） were detected. The levels of malondialdehyde （MDA） and superoxide dismutase（SOD）were measured. The tumor necrosis factor-α（TNF-α） and interleukin 1β（IL-1β） in BALF supernatant were determined by using ELISA method. Results Compared with RL group, PaO2 and pH of arterial blood more increased and PaCO2 of arterial blood more decreased in HSPTX group （ P 〈 0. 01）.The wet/dry lung weight ratio and the percertages of neutrophil in BALF were reduced in HSPTX group. The level of tumor necrosis factor-αand interleukin 1β in HSPTX group were both more significantly decreased than those in RL group （ P 〈0.01）. Conclusions Compared with RL group, the more attenuation of pulmonary inflammation in HSPTX group after shock is associated with less neutrophil activation and decrease in production of the irlammatory cytokines.

关 键 词：己酮可可碱 高渗盐溶液 失血性休克 肺损伤 肿瘤坏死因子α 白细胞介素1 丙二醛 超氧化物歧化酶 

分 类 号：R459.7[医药卫生—急诊医学]