输注不同贮存时间红细胞对内毒素休克家兔急性肺损伤的影响  

Effect of infusion of different storage time suspended red blood cells on acute lung injury in endotoxin shock rabbits

作　　者：康逸群 陶强 张紫薇 汪晓晓 王金伙 徐佳明 李振洲[1] 郭建荣 KANG Yiqun;TAO Qiang;ZHANG Ziwei;WANG Xiaoxiao;WANG Jinhuo;XU Jiaming;LI Zhenzhou;GUO Jianrong(Postgraduate Training Base in Shanghai Gongli Hospital,Ningxia Medical University,Shanghai 200135,China)

机构地区：[1]宁夏医科大学上海市浦东新区公利医院研究生培养基地,200135 [2]海军军医大学附属公利医院麻醉科

出　　处：《临床麻醉学杂志》2021年第4期409-413,共5页Journal of Clinical Anesthesiology

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

摘　　要：目的观察输注不同贮存时间的红细胞对内毒素休克家兔急性肺损伤的影响。方法清洁级健康雄性新西兰家兔48只,6月龄,体重2~2.5 kg,采用随机数字表法分为六组:假手术组(S组)、内毒素休克组(ES组)、内毒素休克+输注贮存1 d红细胞组(R 0组)、内毒素休克+输注贮存1周红细胞组(R 1组)、内毒素休克+输注贮存2周红细胞组(R 2组)和内毒素休克+输注贮存3周红细胞组(R 3组),每组8只。实验前1 d从家兔耳中央动脉采集15%的血容量模拟家兔失血状态。次日ES组、R 0组、R 1组、R 2组和R 3组经耳缘静脉注入脂多糖(LPS)5 mg/kg制备内毒素休克模型,S组静注等量生理盐水。2 h后,S组和ES组给予适量的复方乳酸钠,维持MAP>65 mmHg,R 0组、R 1组、R 2组和R 3组分别输注不同贮存时间的红细胞,输注量为8 ml,为家兔血容量的5%,输血后继续输注适量的复方乳酸钠,维持MAP>65 mmHg。采用ELISA法测定血浆IL-1β、IL-8、TNF-α的浓度。处死家兔后取肺组织,采用HE染色法观察肺组织病理变化、肺损伤评分,测定肺湿/干重比值(W/D);检测肺组织中丙二醛(MDA)含量、髓过氧化物酶(MPO)活性和氧化物歧化酶(SOD)活性。结果与S组比较,ES组、R 0组、R 1组、R 2组和R 3组血浆IL-1β、IL-8、TNF-α浓度明显升高,肺损伤评分、W/D明显增大,肺组织MDA含量明显增加,MPO活性明显升高,SOD活性明显降低(P<0.05)。与ES组比较,R 0组、R 1组、R 2组和R 3组血浆IL-1β、IL-8、TNF-α浓度明显降低,肺损伤评分、W/D明显减小,肺组织MDA含量明显减少,MPO活性明显降低,SOD活性明显升高(P<0.05)。与R 0组比较,R 1组和R 2组血浆IL-8浓度明显升高,R 3组血浆IL-1β、IL-8、TNF-α浓度明显升高,R 1组、R 2组和R 3组肺损伤评分、W/D明显增大,肺组织MDA含量明显增加,MPO活性明显升高,SOD活性明显降低(P<0.05)。与R 1组比较,R 2组血浆IL-8浓度明显升高,R 3组血浆IL-1β、IL-8、TNF-α浓度明�Objective To observe the effect of infusion of different storage time suspended red blood cells on endotoxin shock-induced acute lung injury in rabbits.Methods Forty-eight clean male New Zealand rabbits of six months old,weighing 2.0-2.5 kg,were divided into 6 groups(n=8 for each group)using a random number table method:sham-operated group(group S),endotoxin shock group(group ES),endotoxin shock+storage time of infusing red blood cells 1 day group(group R 0),1 week group(group R 1),2 weeks group(group R 2),and 3 weeks group(group R 3).In groups ES,R 0,R 1,R 2,and R 3,15%blood volume were collected from ear central artery of each rabbit 1 day before the experiment.The next day,endotoxin shock model was induced by injecting lipopolysaccharide through the ear vein,group S was given the same amount of saline.After intravenous injection of LPS or saline for 2 hours,group S and group ES were given an appropriate amount of Sodium Lactate Ringer s solution to maintain MAP>65 mmHg.Groups R 0,R 1,R 2,and R 3 were infused with red blood cells stored for different time,and the infusion volume was 8 ml.After the infusion,an appropriate amount of Sodium Lactate Ringer s solution was added to maintain MAP>65 mmHg.After intravenous injection of LPS for 6 hours,serum concentrations of interleukin-1β(IL-1β),interleukin-8(IL-8),tumor Necrosis Factor-α(TNF-α)in each group were detected by ELISA.Lung tissues were collected from sacrificed rabbits and then stained with haematoxylin,Histopathology(HE),pathological changes,lung injury score and wet-to-dry weight ratios(W/D)were assessed;concentrations of malondialdehyde(MDA),the myeloperoxidase(MPO)activity,and the activity of superoxide dismutase(SOD)in the lung tissue were detected.Results Compared with group S,the serum concentrations of IL-1β,IL-8 and TNF-αwere significantly increased,lung injury score and W/D ratio were significantly increased,the activity of MPO and concentration of MDA were significantly up-regulated,the activity of SOD was significantly decreased in groups

关 键 词：红细胞 贮存时间 内毒素休克 急性肺损伤 

分 类 号：R459.7[医药卫生—急诊医学] R563[医药卫生—治疗学]