聚合人脐带血红蛋白复苏液对失血性休克大鼠肝脏影响初步探究  

Preliminary study on the effect of PolyCHb resuscitation solution on liver tissue of resuscitating hemorrhagic shock rats

作　　者：谢思颖 李遥金[1] 周文涛[1] 李燊[1] 李佳蔚 徐莹璨 王红[1] 杨成民[1] 刘嘉馨[1] XIE Siying;LI Yaojin;ZHOU Wentao;LI Shen;LI Jiawei;XV Yingcan;WANG Hong;YANG Chengmin;LIU Jiaxin(Institute of Blood Transfusion,Chinese Academy of Medical Sciences&Peking Union Medical College,Chengdu 610052,China)

机构地区：[1]中国医学科学院北京协和医学院输血研究所,四川成都610052

出　　处：《中国输血杂志》2020年第3期212-216,共5页Chinese Journal of Blood Transfusion

基　　金：中国医学科学院医学与健康科技创新工程(2016-I2M-1-018、2017-I2M-3-021)。

摘　　要：目的了解聚合人脐带血红蛋白(PolyCHb)复苏液对失血性休克大鼠肝脏组织的影响。方法用改良wiggers法建立大鼠失血性休克模型,将32只健康SD雄性大鼠随机均分为4组:麻醉后大鼠仅行股动/静脉插管的假手术(Sham)组,以及在行股动/静脉插管后分别用羟乙基淀粉(HES)、含20 g/L Hb(2%PolyCHb)、60 g/L Hb(6%PolyCHb)的HES做复苏液行液体复苏的3个实验组。用多通道生理记录仪监测大鼠放血前(基础值)、休克时、复苏后即刻(0 h)的平均动脉压(MAP)和心率(HR);复苏后6 h通过腹主动脉取血处死大鼠,立即检测血液中Hb、Hct、ALT和AST,并随即取右叶肝脏组织制备成10%组织匀浆,用商品化试剂盒测定活性氧簇(ROS)含量和总抗氧化能力(T-AOC),另取左叶肝脏组织固定于10%中性甲醛做病理切片并做病理损伤定性分析。结果2%及6%PolyCHb组与HES组大鼠失血性休克复苏后0 h:MAP(mmHg)分别为111±10.66 vs 132±6.09 vs 85.71±5.25(P<0.01),HR(b/min)分别为329.38±20.71 vs 282.75±48.03(P<0.05)vs 308.71±33.11(P>0.05);复苏后6 h:血液中Hb(g/L)分别为70.75±5.92 vs 84.13±9.33 vs 60.63±8.45(P<0.05),Hct(%)分别为18.75±1.68 vs 18.00±3.20 vs 18.15±2.42(P>0.05),ALT(U/L)分别为197.44±42.08 vs 162.75±44.06 vs 183.96±40.53(P>0.05),AST(U/L)分别为732.41±101.17 vs 737.86±113.90 vs 826.89±78.44(P>0.05),肝脏组织匀浆中ROS(U/ml)分别为419.84±17.76 vs 428.08±17.84(P>0.05)vs 396.21±3.72(P<0.05),T-AOC(mmol/L)分别为0.63±0.01 vs 0.60±0.02 vs 0.67±0.01(P<0.05);病理切片:2%PolyCHb组有中央内皮静脉和免疫细胞浸润方面的损伤,6%PolyCHb组有中央内皮静脉、肝窦和免疫细胞浸润方面的损伤,HES组有中央内皮静脉、内皮细胞、脂肪变性和免疫细胞浸润方面的损伤。结论中、低浓度PolyCHb复苏液和HES一样均能对危重失血性休克大鼠模型有效复苏;降低PolyCHb浓度能减轻肝脏组织在失血性休克液体复苏过程中的病理损伤。Objective To understand the effect of polymerized human cord hemoglobin(PolyCHb)resuscitation solution on hepatic tissue of resuscitating hemorrhagic shock rats.Methods Modified wiggers method was used to establish hemorrhagic shock model in rats.32 healthy SD male rats were randomly divided into four groups(8 rats each group):sham group(only femoral artery/venous intubation after anaesthesia);HES group(femoral artery/venous intubation and resuscitation with HES);2%and 6%PolyCHb groups(femoral artery/venous intubation and resuscitation with corresponding concentration PolyCHb).The mean arterial pressure(MAP)and heart rate(HR)were recorded at the baseline(pre-bleed),shock and immediately after resuscitation(0 h).Rats were sacrificed by bloodletting from the abdominal aorta at 6 h after resuscitation,consequently Hb,Hct,ALT and AST levels in the blood were detected.The right lobe liver tissue was excised to prepare 10%tissue homogenates,the concentration of reactive oxygen species(ROS)and total antioxidant capacity(T-AOC)of it were measured.The left lobe liver tissue was fixed with 10%neutral formaldehyde and the qualitative analysis of liver pathological examination was measured under light microscope.Results 0 h MAP(mmHg)of 2%,6%PolyCHb groups and HES group were 111±10.66 vs.132±6.09 vs.85.71±5.25(P<0.001);HR were 329.38±20.71 vs.282.75±48.03(P<0.05)vs.308.71±33.11(P>0.05);the content of Hb(g/L)were 70.75±5.92 vs.84.13±9.33 vs.60.63±8.45(P<0.05),and the result of Hct(%)were 18.75±1.68 vs.18.00±3.20 vs.18.15±2.42(P>0.05);the plasma ALT activity was 197.44±42.08 vs.162.75±44.06 vs.183.96±40.53(P>0.05),and the AST activity was 732.41±101.17 vs.737.86±113.90 vs.826.89±78.44(P>0.05);the level of ROS(U/mL)was 419.84±17.76 vs.428.08±17.84(P>0.05)vs.396.21±3.72;the T-AOC was 0.63±0.01 vs.0.60±0.02 vs.0.67±0.01(P<0.05);pathological results showed that 2%PolyCHb group had damage to the central endothelial vein and immune cell,6%PolyCHb group had damage to the central endothelial vein,hepatic sinus,a

关 键 词：聚合人脐带血红蛋白 失血性休克 液体复苏 肝损伤 氧化应激 

分 类 号：R331.141[医药卫生—人体生理学] R459.7[医药卫生—基础医学]