携氧代血浆扩容及携氧功能初步动物实验研究  

Preliminary evaluation on the therapeutic efficacy of the oxygen-carrying ability and plasma volume expansion of oxygen-carrying plasma substitute in animal experiment

作　　者：蒋冰玉[1] 李遥金[1] 郝莎莎[1] 桑培培[1] 陈刚[1] 王红[1] 刘嘉馨[1] 

机构地区：[1]中国医学科学院北京协和医学院输血研究所,四川成都610052

出　　处：《中国输血杂志》2016年第4期357-360,共4页Chinese Journal of Blood Transfusion

基　　金：四川省科技支撑计划项目(2013SZ0059;2014SZ0123);四川省国际科技合作与交流研究计划(2014HH0065)

摘　　要：目的建立大鼠重度失血性休克模型和大鼠失血性休克-肠系膜微循环模型,用以探讨携氧代血浆的扩容和携氧功能。方法将20只SD大鼠失血至全身血容量的60%,造成重度失血性休克大鼠模型后,随机均分为6%羟乙基淀粉(HES)组和携氧代血浆组做相应样品的等容量输注复苏。分别在造模前、休克、输液末以及输液后1 h观测大鼠平均动脉压(MAP)、股动脉取血测定血气,检测组织氧分压(PtO_2)。另取20只大鼠建立失血性休克-肠系膜微循环模型,观察、记录大鼠造模前基础值、休克、输液末以及输液后1 h微血管直径的变化和血流状态。结果 HES组与携氧代血浆组比较,输液末微静脉直径(μm)与微动脉直径(μm)分别为:31.23±4.96 vs 31.86±5.43、19.46±1.47 vs19.40±2.10(P>0.05),输液后血流状态均得到恢复;输液后1 h的MAP(mm Hg)为:90.70±3.83 vs 98.90±9.18(P<0.05);组织氧分压(mm Hg)为:输液末7.03±1.47 vs 15.32±2.34(P<0.05),输液后1 h 5.53±2.39 vs 8.90±2.01(P<0.05);2组大鼠血气指标在各时间点相近(P>0.05)。结论携氧代血浆能够改善大鼠失血性休克所致的微循环障碍,具有与HES相似的血管扩容作用,并且在大鼠休克复苏初期恢复组织氧分压的效果优于HES。Objective To establish SD rat models to study severe hemorrhagic shock and mesenteric microcirculation,and to evaluate the efficacy of oxygen-carrying and volume expansion in oxygen-carrying plasma substitute. Methods 20 SD rats subjected to severe hemorrhage（ 60% loss of the total blood volume） were randomly selected to be in the 6% hydroxyethyl starch（ 6% HES） group and oxygen-carrying plasma substitute group for normovolemic transfusion. The mean arterial pressure（ MAP）,femoral arterial blood gas and tissue oxygen partial pressure（ PtO_2） were measured at baseline,shock,the end of resuscitation and 60 min after resuscitation. Another 20 severe hemorrhagic rats were used to investigate the effect of two kinds of fluids on mesenteric microcirculation. The variation in vessel diameter and the state of blood flow were recorded at the same time points. Results At the end of resuscitation,compared with HBOC-HES130,the venule diameter and arteriole diameter（ μm） were 31. 23 ± 4. 96 vs 31. 86 ± 5. 43（ P 0. 05）,19. 46 ± 1. 47 vs 19. 40 ± 2. 10（ P 0. 05）,respectively. One hour after resuscitation,the MAP（ mm Hg） were 90. 70 ± 3. 83 vs 98. 90 ± 9. 18（ P 0. 05）,respectively.The PtO_2（ mm Hg） were 7. 03 ± 1. 47 vs 15. 32 ± 2. 34（ P 0. 05） at the end of resuscitation and 5. 53 ± 2. 39 vs 8. 90 ± 2. 01（ P 0. 05） one hour after resuscitation,while the blood gas parameters did not show any difference in the two groups. Conclusion The oxygen-carrying plasma substitute in the shock model showed similar volume-expansion effects as HES group and was capable of improving mesenteric microcirculation obstruction caused by ischemia. Also,oxygen-carrying plasma substitute demonstrated a better effect on PtO_2 than HES in the initial stage of resuscitation.

关 键 词：携氧代血浆 多聚人胎盘血红蛋白 休克 失血 扩容 复苏 肠系膜微循环 动物实验 SD大鼠 

分 类 号：R457.1[医药卫生—治疗学] R977.8[医药卫生—临床医学]