不同输液量救治失血性休克疗效和脑AQP4表达观察  

The efficacy of different infusion volume and the expression of brain AQP4 in hemorrhagic shock model

作　　者：苏锐冰 陈溢润[1,2] 王典[1] 黄文龙[1] 刘志伟[1] 吕俊耀[1] 于晓军[1] 

机构地区：[1]汕头大学医学院法医学教研室,广东汕头515041 [2]汕头大学医学院附属第二医院ICU,广东汕头515065

出　　处：《中国法医学杂志》2015年第4期363-366,370,共5页Chinese Journal of Forensic Medicine

基　　金：国家和广东省大学生创新性实验项目(20121056010105);"十二五"国家科技支撑计划项目子课题(2012BAK02B02)

摘　　要：目的观察不同输液量救治失血性休克的疗效及其脑组织AQP4的表达。方法家兔28只,左颈总动脉放血建立失血性休克模型,随机分成单纯休克组(A)、常规输液组(B)、大量输液组(C)、正常对照组(D),动态监测血压、心电图和呼吸,HE和AQP4免疫组化(IHC)染色,图像分析技术定量检测各组脑组织间隙相对面积和AQP4表达分布情况。结果 A组死亡率(57.1%)低于C组(85.7%),但两者差异无统计学意义(P>0.05);而B组无死亡。C组脑组织苍白肿胀,HE染色神经元及胶质细胞高度水变性,间质明显疏松,血液稀释、血浆色淡,组织间隙相对面积最大14.83%±8.01%。IHC染色,与B、D组比较,A、C组脑组织AQP4表达明显增多,阳性着色深。定量检测和方差分析各组累积光密度(IOD)差异有统计学意义,P<0.05。结论正常输液量救治休克疗效好,而过量输液死亡率高与脑组织水分过多清除障碍,引起的生命中枢功能障碍有关。Objective To investigate the efficacy of different infusion volume and the expression of brain AQP4 in rabbit hemorrhagic shock model. Methods Twenty-eight rabbits were randomly divided into 4 groups, including the pure shocking group, large infusion group, conventional infusion group and the normal control group. The dynamic monitoring of blood pressure, ECG and respiration, and the quantitative image analysis for HE and AQP4 immunohistochemistry staining were assessed after the rabbit model of hemorrhagic shock established by common carotid artery bleeding. Results No significant difference was shown in mortality between the pure shocking （4/7, 57.1% ） and large infusion group （6/7, 85.7% ） （P 〉 0. 05 ）. There was no death in the conventional infusion group. In the large infusion group, the brain tissue was pale and swelling, and the neurons and glial cells were highly water degenerated, and obvious interstitial loose, hemodilutionand pale blood plasma were observed, and the relative area of gap was the highest （14. 83% ＋ 8.01% ）. The AQP4 expressions in the pure shocking and large infusion group were significantly increased and immunohistochemical stain exhibited a deeper staining, compared to the conventional infusion and normal control group. An analysis of variance demonstrated a statistical significance among each group （P〈0.05） after a quantification for integrated optical density （IOD）. Conclusion Our data show a better improvement of normal infusion for hemorrhagic shock in a rabbit model. The results of the upregulated AQP4 protein and water removing obstacle and brain tissue may contribute to a infusion volume.

关 键 词：法医病理学 AQP4 过量输液 失血性休克 低渗性脑水肿 

分 类 号：D919[医药卫生—法医学]