创伤性休克兔血浆乳酸、肾损伤分子-1的动态变化及亚甲蓝的干预作用  

Dynamic changes of plasma LA and KIM-1 in rabbits with traumatic shock and the intervention of methylene blue

作　　者：王厚清[1] 王鹏[1] 许铁[1] 燕宪亮[1] 梁高永[1] 韩寒[1] 赵宁军[1] 

机构地区：[1]徐州医学院附属医院急救中心,221002

出　　处：《国际麻醉学与复苏杂志》2010年第6期504-507,共4页International Journal of Anesthesiology and Resuscitation

基　　金：徐州医学院附属医院科研课题（2010070）

摘　　要：目的 观察创伤性休克兔血浆乳酸（lactic acid,LA）、肾损伤分子-1（kidney inury molecule-1,KIM-1）的动态变化及鸟苷酸环化酶抑制药亚甲蓝（methylene blue,MB）对创伤性休克兔复苏后肾脏功能的保护作用.方法 大白兔18只,按随机数字表法进行完全随机化分组,分为对照组（n=6）,创伤性休克生理盐水复苏组（NS组,n=6）,创伤性休克MB处理组（MB处理组,n=6）,NS组及MB处理组测定休克前（T1）、休克末（T2）、复苏末（T3）,复苏后2（T4）、4（T5）、6（T6）、8 h（T7）时间点血浆LA、KIM-1水平,对照组测定相应时间点LA、KIM-1水平.结果 对照组各时间点血浆LA及KIM-1水平差异无统计学意义.兔创伤性休克后,血浆LA及KIM-1水平比休克前均有显著升高（P＜0.05）.兔创伤性休克复苏后2、4、6、8 h NS组的LA水平分别为（82.2±3.5）、（93.6±2.6）、（106.5±5.3）、（122.6±4.8）mmol/L,KIM-1水平分别为（8.48±0.31）、（9.29±0.18）、（9.88±0.17）、（10.74±0.45）ng/L,MB组的LA水平分别为（74.7±3.4）、（84.7±2.4）、（94.8±2.6）、（106.8±5.2）mmol/L,KIM-1水平分别为（7.53±0.32）、（8.60±0.34）、（9.41±0.31）、（10.04±0.09）ng/L,MB组LA、KIM-1水平较NS组明显降低（P＜0.05）.结论 创伤性休克可致兔肾功能损害,亚甲蓝能显著改善休克后兔肾功能.Objective To observe the changes of plasma lactic acid（ LA ） and kidney injury molecule-1 （ KIM-1 ） in rabbits with traumatic shock and the intervention of methylene blue （MB）,a guanylate cyclase inhibitor. Methods Eighteen rabbits were randomly divided into 3 groups（n=6）：control group, traumatic shock resuscitation with normal saline group（ NS group ）and traumatic shock resuscitation with methylene blue group （ MB group）. LA and KIM-1 of plasma in NS group, MB group and control group were measured at pre-shock, post-shock, post-resuscitation, 2, 4, 6 h and 8 h after resuscitation respectively. Results The levels of plasma LA and KIM-1 in rabbits after traumatic shock were very higher than that of pre-shock （P＜0.05）. At 2,4,6 h and 8 h after resuscitation, the levels of plasma LA in NS group were （82.2±3.5）, （93.6±2.6）, （ 106.5±5.3 ） and （ 122.6±4.8 ） mmol/L, and the levels of plasma KIM -1 were （8.48 ±0.31 ）, （9.29 ±0. 18 ）, （ 9.88 ±0.17 ） and （ 10.74 ±0.45 ） ng/L. But after resuscitation. But after intravenous administration of MB, the levels of plasma LA were （74.7±3.4）, （84.7±2.4）, （94.8±2.6） and （106.8±5.2） mmol/L and the levels of KIM-1 were（ 7.53±0.32 ）, （ 8.60±0.34 ）, （ 9.41 ±0.31 ） and （ 1 0.04±0.09 ） ng/L respectively, which were obviously lower than that of NS group （P＜0.05）. In control group, there weren＇t significant changes about the levels of LA and KIM-1 among all courses.Conclusion MB can obviously ameliorate the function of kidney and protect the renal tissues in traumatic shock rats.

关 键 词：休克 创伤性 肾损伤分子-1 亚甲蓝 

分 类 号：R641[医药卫生—外科学]