高氧平衡盐溶液对急性一氧化碳中毒性肝损伤的保护作用  

Protective effects of hyperoxygenated banlanced salt solution on liver injury during acute carbon monoxide poisoning

作　　者：徐浩[1] 赵朝华[1] 高兴春[1] 米亚静[1] 王傲迪 苟兴春[1] XU Hao;ZHANG Chao-hua;GAO Xing-chun;MI Ya-jing;WANG Ao-di;GOU Xing-chun(Institution of Basic Medical Science, Xi＇an Medical University, Xi＇an 710021 China)

机构地区：[1]西安医学院基础医学研究所,陕西西安710021

出　　处：《工业卫生与职业病》2018年第3期161-164,共4页Industrial Health and Occupational Diseases

基　　金：国家自科学基金(81500063);陕西省大学生创新创业项目(S201711840031)

摘　　要：目的探索高氧平衡盐溶液(HBS)对急性CO中毒肝损伤的保护作用。方法 SPF级SD大鼠30只随机分为5组,每组6只。N组为正常对照组,C组为CO中毒无治疗对照组,H组为CO中毒HBS治疗组,H组依据静脉输注HBS的剂量分为10(H10组)、15(H15组)和20ml/kg(H20组)。C组与H组均通过腹腔注射CO 120ml/kg建立SD大鼠中毒模型,N组腹腔注射等量的空气。在腹腔注射CO后1.3h,从尾静脉按0.2h恒速输注不同剂量的HBS给各治疗组大鼠,即刻从各组大鼠股动脉取血0.5ml行血气分析,1d后抽取血3ml进行肝损害敏感酶谱的测定,最后取相同部位肝组织行病理学检测。结果腹腔注射CO 120ml/kg后1.5h产生严重的缺氧状态。中毒后天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和谷氨酰转肽酶(GGT)活力明显升高(P<0.01)。CO中毒后24h肝组织放射状分布不清晰,肝细胞索排列不规律,大多数肝细胞水肿或呈空泡样变,可见较多红细胞渗出和中性粒细胞浸润。H组静脉输注不同剂量的HBS后,动脉血氧分压由(45.6±2.4)mm Hg分别上升到(63.9±3.6)、(73.8±3.9)和(78.6±3.8)mm Hg,3种酶均呈现不同幅度的降低,肝组织的病理学变化较C组明显减轻,其中H20组明显降低。结论 HBS用量与结果之间存在一定的量效关系。HBS可明显提高CO急性中毒大鼠的PaO_2和SaO_2,对肝损伤具有很好的保护作用。Objective To explore the protective effect of hyperoxygenated banlanced salt solution（HBS）against liver injury induced by acute carbon monoxide（CO）intoxication.Methods Thirty male Sprague Dawley（SD）rats of grade SPF were randomly divided into five groups（n=6 per group）as follows：Group N as a normal control group（N group）,Group C as a control group of acute carbon monoxide intoxication without treatment（C group）,Group H as a treatment group of acute CO intoxication with HBS（H group）.The different doses of H groups were divided into HBS 10 ml/kg group（named H10 group）,15 ml/kg group（H15 group）and 20 ml/kg group（H20 group）.The rats in the C group,H10 group,H15 group and H20 group were treated with 120 ml/kg CO by intraperitoneal injections.The rats in the N group were treated with120 ml/kg air by intraperitoneal injections.At 1.3 hours after intraperitoneal injection of CO,different doses of HBS were infused according to 0.2 hours constant from the tail vein in the treatment groups.After a constant infusion of different doses of HBS from the tail vein for 12 min in the treatment group,the blood gas analysis of the femoral artery blood 0.5 ml was immediately carried out from every group.At 24 hours after CO injection,3 ml blood samples were extracted to detect the sensitive enzyme spectrum of liver damage.At the end of the experiment,the liver tissues of the same parts of the rats were examined by pathological examination.Results Severe anoxic state was induced by 120 ml/kg CO at 1.5 hafter intraperitoneal injections.AST、ALT and GGT were significantly increased in the C group compared with the N group（P〈0.01）.The HE staining of liver tissue at 24 hafter CO intraperitoneal injections showed：Compared with the N group,the C group of liver tissue structure was significantly disordered,significant swelling steatosis,vacuolar degeneration,significant hepatic lobular vein and hepatic sinus congestion,a large number of erythrocyte and neutrophil infiltrated around central v

关 键 词：高氧平衡盐溶液 CO中毒 肝损伤 血气分析 肝酶谱 

分 类 号：R614.2[医药卫生—麻醉学]