不同血红蛋白浓度对失血性休克复苏家兔肺损伤的影响  

Effects of different hemoglobin concentrations on lung injury in a rabbit model of hemorrhagic shock and resuscitation

作　　者：刘小倩 刘丽 周循 朱娜娜 陈永权[2] 金孝岠[2] 郭建荣 Liu Xiaoqian;Liu Li;Zhou Xun;Zhu Nana;Chen Yongquan;Jin Xiaoju;Guo Jianrong(Department of Anesthesiology,Gongli Hospital,the Naval Military Medical University,Shanghai 200135,China;Department of Anesthesiology,Yijishan Hospital,Wannan Medical College,Wuhu 241000,China)

机构地区：[1]海军军医大学附属公利医院麻醉科,上海200135 [2]皖南医学院附属弋矶山医院麻醉科,芜湖241000

出　　处：《中华麻醉学杂志》2019年第10期1233-1236,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金(81671919,81870147);上海市浦东新区卫生系统重点学科群建设项目(PWZxq2017-10)。

摘　　要：目的评价不同血红蛋白浓度(Hb)对失血性休克复苏家兔肺损伤的影响。方法健康雄性新西兰家兔50只,2月龄,体重1.9~2.4 kg,采用随机数字表法分为5组(n=10):对照组(C组)、休克+液体复苏组(H组)、休克+液体复苏+浓缩RBC输注组:R1组(60 g/L≤Hb<80 g/L)、R2组(80 g/L≤Hb<100 g/L)和R3组(100 g/L≤Hb<120 g/L)。于复苏后3 h时处死家兔取肺组织,光镜下观察肺组织病理学结果,另取肺组织,确定肺组织湿干重(W/D)比值,检测中性粒细胞髓过氧化物酶(MPO)和NO水平,TUNEL法观察肺组织细胞凋亡情况。结果与C组比较,其余各组肺组织MPO和NO水平、W/D比值和细胞凋亡指数升高(P<0.05);与H组比较,R2组和R3组肺组织MPO和NO水平、W/D比值和细胞凋亡指数降低(P<0.05);与R1组比较,R2组和R3组肺组织MPO和NO水平、W/D比值和细胞凋亡指数降低(P<0.05);与R2组比较,R3组T5时细胞凋亡指数升高(P<0.05),其余指标差异无统计学意义(P>0.05)。结论失血性休克复苏后维持Hb 80~100 g/L家兔急性肺损伤程度较轻。Objective To evaluate the effect of different hemoglobin(Hb)concentrations on the lung injury in a rabbit model of hemorrhagic shock and resuscitation(HS-R).Methods Fifty healthy male New Zealand rabbits,aged 2 months,weighing 1.9-2.4 kg,were divided into 5 groups(n=10 each)using a random number table method:control group(group C),HS-R group(group H),and three HS-R plus infusion of concentrated red blood cell groups group R1(60 g/L≤Hb<80 g/L),group R2(80 g/L≤Hb<100 g/L)and group R3(100 g/L≤Hb<120 g/L).The animals were sacrificed at 3 h after resuscitation,lung tissues were obtained for examination of the pathological changes with a light microscope,and lung tissues were obtained again for determination of wet to dry weight ratio(W/D ratio),neutrophil myeloperoxidase(MPO),NO level and cell apoptosis(by TUNEL).Results Compared with group C,the levels of MAP and NO,W/D ratio and apoptosis index were significantly increased in the other groups(P<0.05).Compared with group H,the levels of MAP and NO,W/D ratio and apoptosis index were significantly decreased in R2 and R3 groups(P<0.05).Compared with group R2,the apoptosis index was significantly increased at T5(P<0.05),and no significant change was found in the other parameters in group R3(P>0.05).Conclusion Maintaining Hb 80-100 g/L after HS-R reduces acute lung injury in rabbits.

关 键 词：细胞凋亡指数 液体复苏 血红蛋白浓度 新西兰家兔 肺损伤 肺组织病理学 中性粒细胞 TUNEL法 

分 类 号：R459.7[医药卫生—急诊医学]