新型血红蛋白代用品对创伤失血性休克大鼠重要器官功能的保护作用  

Beneficial effects of a new hemoglobin substitute on functions of vital organs in traumatic hemorrhagic shock rats

作　　者：朱娱[1] 田昆仑[1] 吴跃[1] 张杰[1] 彭小勇[1] 向鑫明 刘良明[1] 李涛[1] ZHU Yu, TIAN Kunlun, WU Yue, ZHANG Jie, PENG Xiaoyong, XIANG Xinming, LIU Liangming, LI Tao(State Key Laboratory of Trauma, Burns and Combined Injury, Department 2, Institute of Surgery Research, Third Affiliated Hospital, Army Medical University （Third Military Medical University） , Chongqing, 400042, China)

机构地区：[1]陆军军医大学(第三军医大学)第三附属医院(野战外科研究所)第二研究室,创伤,烧伤与复合伤国家重点实验室,重庆400042

出　　处：《第三军医大学学报》2018年第19期1729-1734,共6页Journal of Third Military Medical University

基　　金：国家自然科学基金青年科学基金(81700429)~~

摘　　要：目的观察一种新型血红蛋白代用品,产品代号YQ,对非控失血性休克大鼠重要器官的保护作用。方法 1 00只SD大鼠[雌雄各半,12周龄,体质量(220±20) g]随机分为(n=20):0. 5%YQ组、2%YQ组、5%YQ组、乳酸林格氏液(lactate Ringer,LR)对照组和全血组。采用切断脾动脉分支方法构建非控失血性休克模型,观察不同浓度YQ在不同复苏阶段(复苏血压维持50、70、80 mmHg,复苏后1、2h等)对重要脏器(肝、肾)血流量、组织氧分压、器官功能及血气的影响。结果在不同复苏阶段,与LR对照组比较:①3个YQ浓度均可增加大鼠的PaO_2和SaO_2。复苏2 h后2%YQ[(98.8±15. 9) mmHg]和5%YQ组[(98.6±14. 1) mmHg]对PaO_2的作用明显优于LR对照组[(68.6±5.6)mmHg](P <0.01);2%YQ[(92.1±2.5)mmHg]和5%YQ组[(93.6±2.4) mmHg]对SaO_2的作用明显优于LR对照组[(70. 6±8.5) mmHg](P <0.01),接近全血[(94. 3±3. 3) mmHg]。②3个YQ浓度均可增加经皮氧分压,其中5%YQ组效果最好,复苏2 h后其作用[(80.4±5. 9) mmHg]接近全血组[(80.0±7.3) mmHg],与LR对照组比较[(59.1±1.6) mmHg],有显著性差异(P<0.01)。③3个YQ浓度均可增加大鼠的肝肾血流量,其中5%YQ组效果最好,复苏2 h后其作用[肝:(218. 7±13. 8) U/min;肾:(187.4±10.9) U/min]接近全血组[肝:(220.4±18.2) U/min;肾:(179.2±16.3) U/min],明显优于LR对照组[肝:(171.4±20.4) U/min;肾:(169.4±4.7) U/min]。④3个YQ浓度组均可降低大鼠AST、ALT、BUN和Crea水平。与LR对照组比较[AST:(209.6±15.6) U/L;ALT:(54.9±3.6) U/L;BUN:(10.8±2.5) mmol/L;Crea:(47. 7±4. 4)μmol/L],复苏2 h后5%YQ组的肝肾功能[AST:(149.8±13.7)U/L;ALT:(45.9±4.2) U/L;BUN:(9.7±1.8) mmol/L;Crea:(25.8±2. 1)μmol/L]明显减低。结论 YQ通过改善肝、肾器官功能从而发挥对非控制失血性休克大鼠的保护作用。ObjectiveTo investigate the effects of a new type hemoglobin substitute （product code YQ） on main organ functions in uncontrolled hemorrhagic shock rats. MethodsA total of 100 SD rats （50 males and 50 females, at an age of 12 weeks, body weight 220±20 g） were randomly divided into 5 groups： 0.5%YQ, 2.0%YQ, 5%YQ, lactate Ringer’s solution （LR） group, and whole blood group, with 20 rats in each group. After the uncontrolled hemorrhagic shock model was established in the rats by cutting off the splenic artery branch, the effects of different concentrations of YQ on vital organ blood flow （liver and kidneys）, functions of the liver and kidneys, and transcutaneous partial pressures of oxygen and blood gases were tested at vary resuscitation stages （resuscitation being maintained at 50, 70 and 80 mmHg, in 1 and 2 h after resuscitation）. Results①Compared with LR, all 3 doses of YQ increased PaO2 and SaO2 at different resuscitation stages; At 2 h postresuscitation stage, the 2% YQ （98.8±15.9 mmHg） and 5% YQ groups （98.6±14.1 mmHg） showed better effects on PaO2 than the LR group （68.6±5.6 mmHg, P〈0.01）, while so were their effects on SaO2 （92.1±2.5 and 93.6±2.4 vs 70.6±8.5 mmHg, P〈0.01）, which was similar to that of the whole blood group （94.3±3.3 mmHg）. ② All the 3 doses of YQ enhanced the transcutaneous oxygen pressures at different resuscitation stages, and 5% YQ presented the best effect, with its effect closed to that of the whole blood group at 2 h postresuscitation stage （80.4±5.9 vs 80.0±7.3 mmHg）, while significantly higher than that of the LR group （59.1±1.6 mmHg, P〈0.01）. ③ The liver and kidney blood flows were elevated in all the 3 YQ groups at different resuscitation stages. Among them, the 5% YQ had the best effect, with the effects equivalent to those of the whole blood group at 2 h postresuscitation stage （liver： 218.7±13.8 vs 220.4±18.2 U/min; kidneys： 187.4±10.9 vs 179.2±16.3 U/min） and better than those of th

关 键 词：新型血红蛋白代用品 失血性休克 器官功能 大鼠 

分 类 号：R641[医药卫生—外科学] R657.62[医药卫生—临床医学]