高渗盐胶体液对兔脓毒性休克肺组织NF—κB影响的研究  

Research of NF-KB in lung of septic shock rabbit model with hypertonic sodium chloride and hydroxyethyl starch resuscitation

作　　者：王晓燕[1] 李新宇[1] 张雷[1] 周新[1] 任屹[1] 

机构地区：[1]兰州军区乌鲁木齐总医院ICU,新疆830000

出　　处：《中国急救复苏与灾害医学杂志》2013年第1期41-44,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的观察4．2％氯化钠与羟乙基淀粉（130／0．4）混合溶液对兔脓毒性休克复苏肺组织核因子-κB（nuclearfactorkappaB，NF—κB）的影响。方法雄性新西兰大白兔32只，随机分为假手术组（s组）、模型组（M组）、生理盐水复苏组（Ns组）、4．2％高渗盐＋羟乙基淀粉（130／0．4）复苏组（HHS组），每组8只。应用改良盲肠结扎穿孔制作兔脓毒性休克模型。复苏组使用生理盐水（30ml／kg）、4．2％氯化钠与羟乙基淀粉（130／0．4）混合溶液（4ml／kg）静脉滴注10min，复苏4h后处死动物，取肺组织做常规病理学检查及肺组织NF—κB免疫组化，免疫组化组间比较应用平均灰度测定。结果常规HE染色病理学可见s组兔肺组织结构完整，肺泡腔清晰，肺泡间隔组织结构清晰，M组肺泡间隔增宽，肺泡间隔大量炎细胞浸润，肺泡腔内有渗出液、红细胞及炎性细胞；NS组较M组肺组织病理改变略有减轻；HHS组较M组及NS组肺组织病理改变明显减轻。免疫组织化学可见M组、NS组、HHS组肺组织毛细血管NF—κB表达，平均灰度测定结果：与S组相比，M组、Ns组、HHS组肺毛细血管内皮细胞NF—κB灰度值明显减少（P〈0．01）；与M组相比，Ns组肺毛细血管内皮细胞NF—κB平均灰度值减少，但无统计学意义（P〉0．05），HHS组肺毛细血管内皮细胞NF—κB平均灰度值增加（P〈0．05）；与Ns组相比，HHS组肺毛细血管内皮细胞NF—κB平均灰度值明显增加（P〈0．05）。结论脓毒性休克可引起肺毛细血管内皮细胞NF—κB表达活性增高，HHS可能可通过下调肺毛细血管内皮细胞NF—κB表达减轻脓毒性休克肺病理学损伤。Objective To observe the expression of NF-κ B in lung of rabbit septic shock model with 4.2% NaC1 and hydroxyethyl starch （130/0.4） solution resuscitation. Methods Thirty-two adult New-Zealand rabbits were randomly divided into four groups, sham group （S group）, model group （M group）, normal saline resuscitation group （NS group）, and 4.2% NaC1 and hydroxyethyl starch （130/0.4） （HHS group） solution resuscitation group, with eight rabbits in each group. Resuscitation group was resuscitated with NS and HHS for 4 hours before being executed with sodium pentobarbital. Then the lung tissue was observed for HE pigmentation and IHC pigmentation and average gray value. Results The lung＇ s histological structure was integral in sham group, as the structure of alveolar spaces and alveolar septum were clear. However, the alveolar septum widened, and a large number of inflammatory cells in the pulmonary interstitial infiltrated, and the exudates red blood cells and inflammatory cells in the alveolar cavity were detected in the model group and the normal saline group. On the contrary, pathomorphological changes of pulmonary improved significantly in HHS group. The express of NF-κB in endothelium of pulmonary capillaries was seen in M group, NS group and HHS group. Comparing with S group, the average gray value of NF-κB in M group, M group and HHS group deceased significantly （P〈 0.01）. The average gray value of NF-κB reflected no statistical difference between M group and NS group （P〉 0.05）. But the average gray value of NF-KB in HHS group increased comparing to the M group and NS group （P 〈 0.05）. Conclusion The activation of NF-KB in endothelium of pulmonary capillaries is considered to increase in rabbit septic shock model as HHS relieves lung injury caused by septic shock through decreasinz the NF-κB in lunz.

关 键 词：脓毒性休克 复苏 肺 NF—κB 

分 类 号：R441.9[医药卫生—诊断学]