羟乙基淀粉早期液体复苏对感染性休克新生兔肝脏的保护作用  

Hepatic Protection by Early Fluid Resuscitation with Hydroxyethyl Starch on Septic Shock in Newborn Rabbits

作　　者：余锦芬[1] 叶小丰[1] 余凌[1] 曹苇[1] 

机构地区：[1]湖北省妇幼保健院麻醉科,武汉430070

出　　处：《医药导报》2011年第11期1418-1421,共4页Herald of Medicine

摘　　要：目的研究羟乙基淀粉(hydroxyethyl starch,HES)早期液体复苏对感染性休克新生兔肝脏的保护作用。方法接受盲肠结扎穿孔法手术的健康新西兰长耳新生兔60只,随机分为3组,每组20只:①感染性休克组(Ⅰ组,不给予液体),②HES 10 mL.kg-1+乳酸林格液20 mL.kg-1组(Ⅱ组),③HES 30 mL.kg-1(Ⅲ组)。均行左颈总静脉与右颈总动脉置管,通过左颈总静脉置管,用微量输液泵输注规定的液体1 h,经右颈总动脉连续监测平均动脉压(mean arterypressure,MAP),观察一般情况并测定术后8 h肝脏核因子κB表达情况,苏木精-伊红染色,光镜下观察肝脏改变,检测动脉血气变化。结果与本组0 h比较,Ⅰ组MAP呈进行性下降,Ⅱ、Ⅲ组血压无明显改变;与Ⅰ组比较,Ⅱ组、Ⅲ组2 h后血压增高,均差异有统计学意义(P<0.05)。与Ⅰ组比较,Ⅱ、Ⅲ组动脉血氧分压升高,均差异有统计学意义(P<0.05)。各组间动脉血pH、动脉血二氧化碳分压变化差异无统计学意义。与Ⅰ组比较,Ⅱ、Ⅲ组肝细胞内核因子κB抗原表达明显降低;与Ⅱ组比较,Ⅲ组肝细胞内核因子κB抗原表达增高,差异有统计学意义(P<0.05)。结论采用HES进行早期液体复苏对感染性休克新生兔肝脏有保护作用,10 mL.kg-1作用更强。Objective To study the hepatic protective effect of early fluid resuscitation with hydroxyethyl starch（HES） on septic shock in newborn rabbits. Methods 60 New Zealand longear newborn rabbits received cecal ligation and puncture（CLP）were randomly divided into three groups（20 rabbits/group）：group I（CLP without liquid）,group II（CLP,HES 10 mL·kg-1 plus lactate Ringer＇s injection 20 mL·kg-1）,group III（CLP,HES 30 mL·kg-1）.The right carotid artery of rabbits were annulated with a microtip transducer for continuous recording of MAP during the experiment process.The left carotid vein was catheterized to infuse the fixed fluid for 1 hour.Arterial blood samples were taken for blood gas analysis,liver was stained with HE and observed under microscope,and NF-κB protein levels in hepatic tissue were measured at 8 h after CLP. Results Compared with MAP at 0 h,which gradually decreased in group I.No obvious change of blood pressure appeared in both group Ⅱ and Ⅲ.In comparison to group I,blood pressure was elevated after 2 h in group II and Ⅲ（P0.05）.The artery PaO2 was higher in groupⅡ and Ⅲ than that in group I（P0.05）.No significant difference in pH and PaCO2 were found among three groups.The expression of NF-κB protein in hepatocyte was stronger in group I than that in group Ⅱ and Ⅲ,and which was more in group Ⅲ than in group Ⅱ（P0.05）. Conclusion Early fluid resuscitation with HES,especially at 10 mL·kg-1 prosessed protective effect on septic shock in newborn rabbits.

关 键 词：羟乙基淀粉 核因子ΚB 休克 感染性 

分 类 号：R973.5[医药卫生—药品] R965[医药卫生—药学]