高渗氯化钠溶液复苏失血性休克红细胞内ATP和2.3-DPG水平变化  

The Effect of 7.5% Hypertonic saline as a Resuscitation Solution for Hemorrhagic Shock on the Energy matabolism in Erythrocyte

作　　者：卢家凯 刘怀琼[2] 潘贤佖[1] 汪志文[3] 

机构地区：[1]军区总医院麻醉科 [2]第三军医大学大坪医院麻醉科 [3]第三军医大学野战外科研究所中心室

出　　处：《解放军医药杂志》1997年第1期4-6,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：本文观察了兔失血性休克及应用小剂量7.5％HS(4ml/kg)复苏时RBC内ATP和2,2.3—DPG水平的变化。20只成年健康家兔被随机分为正常血容量输注HS组、休克输注NS复苏组、休克输注HS复苏组三组。结果显示休克后RBC内ATP和2,3—DPG水平显著下降,应用小剂量HS复苏后两项指标均有所回升,在输注后120分钟有显著增高。由于RBC内ATP和2,3—DPG水平是反映RBC能量代谢的主要指标,而RBC代谢状态又可通过影响RBC诸多功能影响组织的氧代谢和休克的转归。因此,笔者认为应用小剂量HS复苏失血性休克的同时RBC能量代谢状态也发生明显改善,这可能是促进HS有效复苏休克的重要因素。To evaluate the effect of 7. 5% hypertonic saline ( HS) on the energy matabolism in erythrocyte, 20 adUit rabbits were devided into three experimental groups randoml y. Hemorrhagic shock was induced by slow bleeding from femoral artery, with MAP being reduced to 5. 3kPa and being kept at this level for one hour . The animals with normovolemiaf group A, n = 5) were infused intravenously with HS 4ml/kg , and the others with hemorrhagic shock were resuscitated with NS 4ml/kg(group B, n= 6) or HS 4ml/kg (group C, n =9) . BLood samples were taken, before shock, immediately following shock and 10, 30, 60, and 120min after the infusion of HS or NS , to measure the intracellular concentration of ATP and 2,3 - DPG in ervthrocyte. MAP was monitered continuously, the results show that the level of intracellular ATP and 2,3- DPG decreased after shock and both of them increased gradually with the infusion of HS, and of statistical aigriifcance at the point of 120min after the infusion , The regults demonstrated thyat the matabolism condition of energy in erythrocyte after hemorrhagic shock is improved by the resuscitating with small - volume HS infusion and this may result in an improvement of t0he functions of erythrocyte and the oxyge matabolism of tissues.

关 键 词：高渗氯化钠 失血性休克 红细胞 三磷酸腺苷 2 3—二磷酸甘油酸 

分 类 号：R605.971[医药卫生—急诊医学]