不同输液量对家兔失血性休克的救治效果及心钠素的影响  

Effect of Different Infusion Volume on Hemorrhagic Shock in Rabbits and Effect of Atrial Natriuretic Peptide

作　　者：刘志伟 于晓军[2] 雷怀成 苏锐冰 黄文龙[2] 王典[2] LIU Zhi-wei;YU Xiao-jun;LEI Huai-cheng;SU Rui-bing;HUANG Wen-long;WANG Dian(Department of Forensic Medicine, Hubei University of Medicine, Shiyan, Hubei 442000;Department of Forensic Medicine, Shantou Uni- versity Medical College, Shantou , Guangdong 515041, China)

机构地区：[1]湖北医药学院基础医学院法医学教研室,湖北十堰442000 [2]汕头大学医学院法医教研室,广东汕头515041

出　　处：《湖北医药学院学报》2018年第3期221-224,F0003,共5页Journal of Hubei University of Medicine

基　　金：广东省大学生创新性实验项目(1056010105)

摘　　要：目的:在法医鉴定中,常遇到因过量输液引发循环超负荷致死案例,本研究探讨不同输液量救治失血性休克过程中对心脏及其心钠素(Atrial natriuretic peptide,ANP)表达的影响。方法:成年家兔分对照组、模型组(失血性休克)、常规组(失血性休克常规输液)、观察组(失血性休克大量输液),7只每组,建立失血性休克模型,动态监测生命体征、心肌HE染色、ANP的免疫组化染色并使用图像分析技术定量心肌间隙总面积和ANP表达情况。结果:各组心肌间隙不同程度水肿,观察组HE染色心肌间隙总面积、ANP免疫组化表达均高于其他组(P<0.05)。结论:失血性休克过量输液加重心脏负荷,引起心肌损害,增加死亡风险。Objective In forensic identification,the cases of cyclic overload caused by excessive infusion are often encountered. This study was to investigate the effect of different infusion volumes on the expression of atrial natriuretic peptide（ ANP） during the hemorrhagic shock.Methods Adult rabbits were divided into control group,model group（ hemorrhagic shock）,conventional group（ hemorrhagic shock conventional infusion）,observation group（ heavy hemorrhagic shock,large infusion）,7 rabbits in each group.The established hemorrhagic shock model was established on all rabbits. Dynamic monitoring of vital signs,myocardial HE staining,immunohistochemical staining of ANP and image analysis technique were used to quantify the total area of myocardial interstitial and ANP expression.Results There were different degrees of edema in each group. The total area of HE stained myocardial interstitial and the immunohistochemical expression of ANP were higher in the observation group than in the other groups（ P〈0.05）.Conclusion Excessive infusion of hemorrhagic shock aggravates cardiac burden,causes myocardial damage,and increases the risk of death.

关 键 词：法医病理学 输液 心衰 心钠素 失血性休克 

分 类 号：R459.7[医药卫生—急诊医学]