高渗氯化钠羟乙基淀粉40注射液对创伤失血性休克兔血浆内皮素-1水平的影响  

Influence of hypertonic sodium chloride hydroxyethyl starch 40 injection on plasma endothelin-1 of rabbits with hemorrhagic traumatic shock

作　　者：刘变化[1] 张思森[2] 王国涛[3] 刘青[2] 

机构地区：[1]新乡医学院,河南新乡453003 [2]郑州人民医院急诊科,河南郑州450000 [3]南方医科大学研究生学院,广东广州510515

出　　处：《新乡医学院学报》2016年第3期178-181,共4页Journal of Xinxiang Medical University

基　　金：河南省医学科技重点攻关计划项目(编号:201303221);郑州市科技领军人才重点项目(编号:131PLJRC682);郑州市普通科技攻关计划项目(编号:20130595;20140452)

摘　　要：目的探讨高渗氯化钠羟乙基淀粉40注射液（HHS）对创伤失血性休克兔在限制性液体复苏过程中对血浆内皮素-1（ET-1）水平的影响。方法选取健康新西兰兔36只,随机分为2组,每组18只,A组兔给予9 g·L-1氯化钠＋60 g·L-1羟乙基淀粉,B组兔给予42 g·L-1氯化钠＋76 g·L-1羟乙基淀粉。分别于休克时（T0）及复苏后0.5（T1）、1.0（T2）、1.5（T3）、2.0 h（T4）检测平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、血细胞比容（Hct）、血红蛋白（Hb）、C反应蛋白（CRP）、凝血酶原时间（PT）、活化部分凝血酶时间（APTT）及血浆ET-1水平,并进行比较分析。结果 A组兔T2～T4时MAP、HR、RR较T0增加（P〈0.05）;B组兔T2～T4时MAP较T0升高,HR、RR较T0降低（P〈0.05）。B组兔T1～T4时HR、RR低于A组（P〈0.05）,MAP高于A组（P〈0.05）。A组兔T2～T4时Hb、Hct较T0时显著下降（P〈0.05）;B组兔T1～T4时Hct与T0比较差异无统计学意义（P〉0.05）,而T2～T4时Hb水平较T0时下降（P〈0.05）;2组兔T1～T4时CRP水平均高于T0时（P〈0.05）。B组兔T1～T4时CRP水平较A组降低（P〈0.05）。A组兔PT水平在各时间点比较差异均无统计学意义（P〉0.05）,APTT在T2～T4时较T0延长（P〈0.05）;B组兔T2～T4时PT水平较T0时延长（P〈0.05）;与A组比较,B组兔T2～T4时PT延长、APTT缩短（P〈0.05）。2组兔T1～T3时ET-1水平逐渐升高,于T3时达最大值（P〈0.05）。2组兔T0、T1时血浆ET-1水平比较差异无统计学意义（P〉0.05）,B组兔T2～T4时ET-1水平低于A组（P〈0.05）。结论 HHS在兔创伤失血性休克早期可降低血浆ET-1水平,能够更好地改善全身供血情况,纠正组织低灌注,保护心、脑、肺等重要组织。Objective To observe the influence of hypertonic sodium chloride hydroxyethyl starch 40 injection（ HHS）on plasma endothelin-1（ ET-1） level of rabbits with hemorrhagic traumatic shock. Methods Thirty-six healthy rabbits were divided into two groups randomly,with 18 in each group. The rabbits in group A were given 9 g · L- 1saline ＋ 60 g · L- 1hydroxyethyl starch,while the rabbits in group B were given 42 g·L- 1saline ＋ 76 g·L- 1hydroxyethyl starch. The levels of mean arterial blood pressure（ MAP）,heart rate（ HR）,respiratory rate（ RR）,haematocrit（ Hct）,hemoglobin（ Hb）,C-reactive protein（ CRP）,prothrombin time（ PT）,activated partial thromboplastin time（ APTT） and plasma ET-1 were detected at schocking（ T0） and 0. 5（ T1）,1. 0（ T2）,1. 5（ T3）,2. 0 h（ T4） after anabiosis,the results were compared between the two groups. Results The levels of MAP,HR and RR in group A at T2- T4 were higher compared with those at T0（ P〈 0. 05）.The level of MAP in group B at T2- T4 was higher than that at T0,while the levels of HR and RR at T2- T4 were lower than those at T0（ P〈 0. 05）. The levels of HR and RR in group B were lower than those in group A（ P〈 0. 05）,while the MAP in group B was higher than that in group A（ P〈 0. 05）. There was no significant difference in Hct at T1- T4 compared with that at T0 in group B（ P〈 0. 05）,while the Hb at T2- T4 decreased more significantly（ P〈 0. 05）. The level of CRP in the two groups at T1- T4 was higher compared with that at T0（ P〈 0. 05）. The level of CRP in group B at T1- T4 was lower than that in group A（ P〈 0. 05）. There was no significant difference in PT among the different time points in group A（ P〈 0. 05）,APTT at T2- T4 was longer than that at T0 in group A（ P〈 0. 05）. The PT at T2- T4 in group B was longer than that at T0（ P〈 0. 05）. Compared with group A,PT at T2- T4 was longer,APTT was shorter in group B（ P〈 0. 05）. The level of ET-1 at T1-T3 in th

关 键 词：高渗氯化钠羟乙基淀粉40注射液 创伤失血性休克 内皮素 限制性液体复苏 

分 类 号：R45[医药卫生—治疗学]