不同溶液小容量复苏对内毒素休克大鼠肾组织病理和氧化应激的影响  

Impact of small-volume resuscitation using distinct solutions on tissue pathology and oxidative stress in rats with endotoxin shock

作　　者：余高锋 庞红宇[2] 郭娜[2] 李晓芸[2] 黑子清[2] 陈景晖[2] 

机构地区：[1]广州市妇女儿童医疗中心麻醉科,510623 [2]中山大学附属第三医院麻醉科

出　　处：《中华生物医学工程杂志》2011年第6期491-495,共5页Chinese Journal of Biomedical Engineering

摘　　要：目的 探讨7.5％高渗氯化钠、羟乙基淀粉液130/0.4（万汶）和高渗氯化钠羟乙基淀粉不同液体小容量复苏对内毒素休克大鼠肾损害及超氧化物歧化酶（SOD）和丙二醛（MDA）的影响.方法 30只SD大鼠完全随机分5组（n=6）：正常组（N组）、内毒素休克组（LPS,E组）、7.5％高渗氯化钠溶液复苏组（LPS＋HSS,HSS组）、羟乙基淀粉液130/0.4（万汶）复苏组（LPS＋HES,HES组）、高渗氯化钠羟乙基淀粉40溶液复苏组（LPS＋HSH,HSH组）.除N组外,各组在静注内毒素（LPS）后进行小容量复苏.记录不同时间点心率及收缩压.复苏60 min后取肾标本行病理学检查,测定肾皮质匀浆MDA浓度和SOD活性,计算肾干湿质量比.结果 内毒素休克大鼠心率增快、动脉收缩压下降；复苏后心率减慢,动脉血压回升.E组局部出现肾小管坏死、肾小球足突融合、基底膜沉积物；复苏组病理改变减轻.E组SOD活性下降[（125.27±32.28） U/ml比（340.53±42.25） U/ml,P＜0.05]；MDA含量增加[（1.08±0.15）μmol/L比（0.35±0.08）μmol/L,P＜0.05].小容量复苏后,HES和HSH复苏组MDA含量下降[（0.64±0.18） μmol/L和（0.63±0.15） μmol/L比（1.08±0.15）μmol/L,P＜0.05]；HSS、HES和HSH组的SOD活性增强[ （233.06±75.60） U/ml和（210.21±52.73） U/ml和（231.22±77.78） U/ml比（125.27±32.28）U/ml,P＜0.05].结论 内毒素休克大鼠肾损伤明显,不同液体小容量复苏后氧化损伤减轻,肾脏病理改变减轻.Objective To investigate the effects of small-volume resuscitation using 7.5% sodium chloride,hydroxyethyl starch 130/0.4 （WanwenTM） and hyperosmic sodium chloride on renal injury,superoxide dismutase （SOD） and malonaldehyde （MDA） in rats with endotoxin shock.Methods Thirty SD rats weighting 180 g-250 g were randomized into 5 groups （n=6）：normal control （group N）,endotoxin shock group （LPS,group E）,7.5% hyperosmic sodium chloride solution resuscitation group （LPS＋HSS,group HSS）,hydroxyehtyl starch solution 130/0.4 resuscitation group （LPS ＋ HES,group HES）,and hyperosmic sodium chloride with hydroxyethyl starch 40 solution resuscitation group （LPS ＋ HSH,group HSH）.Small-volume resuscitation was administrered after LPS injection except for group N.Heart rate and systolic pressure were recorded at different time points.The renal pathological examination was performed after 60 minutes,and the renal cortex MDA level and superoxide dismutase activity were measured.The ratio of dry/wet weight of kidney was also calculated.Results Rats with sepsis had a higher heart rate and lower systolic pressure followed by lower heart rate and increased arterial blood pressure after resuscitation.Pathological changes in terms of renal tubular necrosis,foot process fusion and basement membrane thickening occurred in group E and were ameliorated in resuscitation groups.In group E,SOD activity was reduced [ （ 125.27 ±32.28 ） U/ml vs （ 340.53 ±42.25 ） U/ml,P〈0.05 ] and MDA increased [ （ 1.08 ±0.15 ） μmol/L vs.（0.35±0.08） μmol/L,P〈0.05].A reduction in MDA content was found in group HES and HSS [ （0.64±0.18） μmol/L and （0.63±0.15） μmol/L vs（1.08±0.15） μmol/L,P〈0.05],and increased activity of SOD was shown after small- volume resuscitation [ （233.06± 75.60） U/ml and （210.21 ± 52.73） U/ml and （231.22 ±77.78 ） U/ml vs （125.27±32.28）U/ml,P〈0.05].Conclusion Oxidative lesion and pathological changes of renal injury are lessened in rats

关 键 词：内毒素血症 心肺复苏术 肾功能衰竭 丙二醛 超氧化物歧化酶 

分 类 号：R459.7[医药卫生—急诊医学]