丙酮酸盐替代乳酸盐腹膜透析液腹腔复苏对失血性休克家兔肠黏膜屏障的影响  

Effect of pyruvate replacing lactate dialysis solution peritoneal resuscitation on intestinal mucosal barrier of rabbit with hemorrhagic shock

作　　者：罗兴均 钟和英 冉然 田刚 简道林[2] 卢啸 

机构地区：[1]湖北医药学院附属人民医院麻醉科,湖北十堰442000 [2]三峡大学仁和医院麻醉科,湖北宜昌443001

出　　处：《重庆医学》2017年第35期4904-4907,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81201460)

摘　　要：目的观察丙酮酸盐替代乳酸盐腹膜透析液行腹腔复苏对失血性休克家兔肠黏膜屏障的影响。方法雄性健康家兔48只以Wiggers改良方法制备失血性休克模型,将其分为常规静脉复苏组(A组)、常规静脉复苏+腹腔注射乳酸盐腹膜透析液组(B组)、常规静脉复苏+腹腔注射丙酮酸盐腹膜透析液组(C组)和静脉丙酮酸盐液复苏+腹腔注射丙酮酸盐腹膜透析液组(D组)。检测休克前、休克后60min及复苏后60、180min静脉血二胺氧化酶(DAO)和脂多糖(LPS)水平。于观察终点取距回盲部5cm的一段回肠,测定组织干/湿质量比、丙二醛(MDA)水平及超氧化物歧化酶(SOD)活性,并观察其病理形态学改变。结果 4组休克前血浆DAO、LPS水平比较,差异均无统计学意义(P>0.05);休克后60min均较休克前升高,但组间比较差异均无统计学意义(P>0.05);复苏后60、180min,A、B、C、D组血浆DAO、LPS水平依次降低(P<0.05)。复苏后180min,A、B、C、D组回肠组织MDA水平依次降低(P<0.05),SOD活力水平、组织干/湿质量比依次升高(P<0.05),且组织损伤程度也依次减轻。结论丙酮酸盐替代乳酸盐腹膜透析液腹腔复苏可更有效地保护失血性休克家兔肠组织细胞和减轻肠黏膜损伤。Objective To observe the effects of peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution on the intestinal mucosal barrier in rabbits with hemorrhagic shock. Methods The hemorrhagic shock model was prepared in 48 healthy male rabbits by adopting the improved Wiggers method. Then the rabbits were randomly divided into the conventional intravehous resuscitation group （group A）, conventional intravenous resuscitation plus intraperitoneal injection of lactate peritoneal dialysis solution group （group B） ,conventional intravenous resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis solution group （group C） and intravenous pyruvate peritoneal dialysis solution resuscitation plus intraperitoneal injection of pyru- vate peritoneal dialysis solution group （group D）. The levels of diamine oxidase （DAO） and lipopolysaceharide （LPS） were meas- ured before shock,at 60 min after shock,at 60,180 min after resuscitation. At the end of observation, the ileum tissues were taken from the 5 cm away from the ileoceeal region for measuring the dry/wet ratio,malondialdehyde （MDA） level and superoxide dis mutase （SOD） activity and their morphological changes was observed. Results There was no statistical difference in the plasma levels of DAO and LPS before shock among the four groups （P〉0. 05） ;which at 50 rain after shock were increased,but the comparison among the groups had no statistical difference （P〉0.05） ;the plasmas levels of DAO and LPS at 60,180 min after resuscitation in the group A,B,C and D were decreased in turn （P〈0.05）. The MDA levels of ileum tissues after 180 rain of resuscitation in the group A,B,C and D were decreased in turn （P〈0. 05） ,but the SOD activties and tissue dry/wet mass ratios were increased in turn （P〈005） ,moreover the tissue injury degrees were also relieved in turn. Conclusion The peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution can more effectively p

关 键 词：休克 出血性 丙酮酸盐 腹腔复苏 肠黏膜 

分 类 号：R459.7[医药卫生—急诊医学]