肾素-血管紧张素-醛固酮系统在猪失血性休克后深低温救治与单纯低温应激过程中变化研究  

Study of RAAS on the treatment of deep hypothermia and low temperature stress after pig hemorrhagic shock

作　　者：徐殊[1] 王辉山[1] 尹宗涛[1] 刘宇[1] 韩劲松[1] 张永[1] XU Shu;WANG Hui-shan;YIN Zong-tao;LIU Yu;HAN Jin-song;ZHANG Yong(Department of Cardiovascular Surgery,The General Hospital of Shenyang Military Command,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院心血管外科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第8期874-877,共4页Clinical Journal of Medical Officers

基　　金：军队装备研制项目重大项目(ASY135001);辽宁省自然科学基金计划重点项目(20170540977)

摘　　要：目的探讨猪失血性休克后常温救治、深低温及持续低温环境液体复苏救治过程中肾素-血管紧张素-醛固酮系统(RAAS)的变化,分析环境低温与控制性诱导低温对失血性休克复苏过程的影响。方法将30只小型巴马香猪随机分为常温组(n=5)、低温转流组(n=20)和低温应激组(n=5)。比较建立失血性休克模型前、建模后30 min、建模后2、4 h,3组实验猪血清血管紧张素转换酶(ACE)、血管紧张素Ⅱ(AngⅡ)水平。结果建模前与建模后30 min,3组血清ACE、AngⅡ含量检测结果比较,差异无统计学意义(P>0.05)。建模后2 h,低温应激组血清ACE、AngⅡ含量明显高于常温组和低温转流组,差异均有统计学意义(P<0.05)。建模后4 h,低温转流组血清ACE、AngⅡ含量明显低于常温组和低温应激组,差异均有统计学意义(P<0.05)。结论失血性休克可使机体RAAS激活,低温环境可加快该进程。采用可控性深低温转流复苏救治失血性休克,可抑制机体重度创伤后的炎症、氧化应激反应,有利于提高救治成功率。Objective To explore the change of renin-angiotensin-aldosterone system（ RAAS） on the treatment of deep hypothermia and low temperature stress after pig hemorrhagic shock. Methods Totally 30 small Bama miniature pigs were randomly divided into normal temperature group（ n = 5）,low temperature bypass group（ n = 20） and low temperature stress group（ n = 5）. The angiotensin converting enzyme（ ACE） and the angiotensinⅡ（ AngⅡ） were compared at the hemorrhagic shock model established ago,30 minutes after model established,2 and 4 hours after model established among the three groups. Results Before the model established and after the model established,the level of ACE and Ang Ⅱ were no significant difference among the three groups（ P〈0. 05）. Two hours after the model established,the level of ACE and Ang Ⅱ of the low temperature stress group higher than those of the normal temperature group and the low temperature bypass group,there were significant difference（ P〈0. 05）. Four hours after the model established,the level of ACE and Ang Ⅱ of the low temperature bypass group lower than those of the normal temperature group and the low temperature stress group,there were significant difference（ P〈0. 05）. Conclusion RAAS was activated by hemorrhagic shock,low temperature can speed up the process. Hemorrhagic shock cured by controlled deep and low temperature diversion resuscitation can inflammation and oxidative stress after severe trauma.

关 键 词：失血性休克 深低温 转流 肾素-血管紧张素-醛固酮系统 

分 类 号：R459.7[医药卫生—急诊医学]