盐酸戊乙奎醚对失血性休克大鼠急性肺损伤的影响  

Effects of penehyclidine hydrochloride on hemorrhagic shock-induced acute lung injury in rats

作　　者：黎笔熙[1] 陶军[2] 朱水波[3] 张晓明[3] 宋晓阳[2] 刘雷霆[3] 殷桂林[3] 

机构地区：[1]南方医科大学研究生院,广州510515 [2]广州军区武汉总医院麻醉科 [3]广州军区武汉总医院心胸外科

出　　处：《中华实验外科杂志》2014年第11期2486-2489,共4页Chinese Journal of Experimental Surgery

基　　金：全军医学科研“十一五”计划资助项目（06G048）;湖北省卫生厅2011-2014年科研基金资助项目（JX5B40）

摘　　要：目的 观察盐酸戊乙奎醚（PHC）对失血性休克及容量复苏所导致的大鼠急性肺损伤的影响.方法 将15只无特定病原体（SPF）级雄性SD大鼠随机均分为PHC组（P组）、对照组（C组）和假手术组（S组）,P组和C组通过颈动脉放血建立休克模型,维持1h后用自体血进行容量复苏.P组大鼠容量复苏前静脉注射PHC 0.03 mg/kg（1.0 ml）.分别于颈动脉穿刺置入套管针后（T0）、休克制模前（T1）、休克成模后5 min（T2）、开始容量复苏前（T3）、复苏至预定血压后5 min（T4）、容量复苏后30 min（T5）、1.5 h（T6）和2.5 h（T7）等8个时间点采集血标本测定白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）以及核转录因子-κB（NF-κB）水平,并于T0、T3和T7等3个时间点监测动脉血气.实验结束后取右下肺叶观察肺组织病理变化.结果 T7时P组和C组PO2/FiO2显著低于S组[（289.5±67.1）mmHg（1 mmHg=0.133 kPa）、（280.0±73.3） mmHg比（458.1±31.0） mmHg,P＜0.01].P、C和S组大鼠肺组织病理评分[（4.4±1.7）、（7.4±1.9）分比（0.8±1.1）分]差异有统计学意义（P＜0.01）;血清IL-8[（7.35 ±0.14）、（8.44 ±0.13） ng/L比（3.75±0.06） ng/L]、TNF-α[（8.45±0.24）、（9.69±0.52） ng/L比（4.19 ±0.04） ng/L]和NF-κB[（272.34±12.60）、（310.00± 16.47） ng/L比（133.98±1.91） ng/L]峰值浓度组间比较差异有统计学意义（P＜0.01）.结论 PHC可以使失血性休克及容量复苏大鼠体内的炎性介质释放减少、减轻肺组织病理评分,提示PHC具有肺保护效应;PHC对休克复苏后肺损伤保护效应的机制可能与减少IL-8和TNF-α等炎性因子的释放和表达、抑制NF-κB等信号通路有关.Objective To observe the effects of penehyclidine hydrochloride （PHC） on hemorrhagic shock/resuscitation-induced acute lung injury in rats.Methods Fifteen healthy adult Sprague-Dawley rats were randomly allocated equally into three groups：groups P,C and S.The rats in group S received sham operation,and those in groups P and C were subjected to bloodletting for shock,then shock state maintained for 60 min,and resuscitation was done with autoblood.The rats in group P received PHC treatment （0.03 mg/kg） before resuscitation of hemorrhagic shock,and those in group C and group S received 1.0 ml normal saline instead.Blood samples were collected via the carotid artery for interleukin-8 （IL-8）,tumor necrosis factor-α （TNF-α） and nuclear factor-κB （NF-κB） monitoring at the time of subsequence carotid arteriopuncture （T0）,before shock induction （T1）,5 min after shock （T2）,before resuscitation of shock （T3）,5 min （T4）,30 min （T5）,1.5 h （T6） and 2.5 h （T7） after mean arterial pressure （MAP） reached expected resuscitation goal.The arterial blood gas analyses were detected at T0,T3 and T7.The morphological changes of lungs were observed under microscope.Results The ratio of PO2/FiO2 in groups P and C were significantly lower than in group S at T7 [（289.5 ± 67.1） mmHg （1 mmHg =0.133 kPa）,（280.0 ±73.3） mmHg vs.（458.1 ±31.0） mmHg,P 〈0.01].There was marked diversity among group P,C and S in the morphological score （4.4 ± 1.7,7.4 ± 1.9 vs.0.8 ± 1.1,P 〈0.01） ; The peak concentrations of IL-8 [（7.35 ±0.14）,（8.44 ±0.13） ng/L vs.（3.75 ±0.06） ng/L,P 〈0.01],TNF-α [（8.45 ±0.24,（9.69 ±0.52） ng/L vs.（4.19 ± 0.04） ng/L,P〈0.01] and NF-κB [（272.34 ± 12.60）,（310.00 ± 16.47） ng/L vs.（133.98 ± 1.91） ng/L,P 〈 0.01] respectively,with significant difference among three groups.Conclusion Treatment of PHC might have a protective effect against lung injury induced by hemorrhagic shock/resuscitation.Its action m

关 键 词：失血性休克 急性肺损伤 盐酸戊乙奎醚 炎性因子 

分 类 号：R459.7[医药卫生—急诊医学]