重组血红蛋白对大鼠失血性休克的治疗效果  

Therapeutic effects of recombinant hemoglobin in rats with hemorrhagic shock

作　　者：刘金锋[1] 李文志[1] 李德辉[1] 岳子勇[1] 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科,150086

出　　处：《中华麻醉学杂志》2003年第6期439-442,共4页Chinese Journal of Anesthesiology

摘　　要：目的 探讨两种重组血红蛋白及清蛋白对失血性休克的治疗效果。方法24只大鼠随机等分为3组,由股动脉抽血建立失血性休克模型,保持平均动脉压(MAP)40 mm Hg45 min。休克后对照组输入人体清蛋白(HSA),其他两组分别输入重组血红蛋白rHb 1.1和rHb 2.0。测定休克前后不同时间点MAP、肠系膜上动脉血流、股动脉血气和肠系膜上静脉血气值。结果 rHb 1.1输入后30rainMAP显著高于休克前(P<0.01)和其他两组(P<0.05);在休克后各时间点上,肠系膜上动脉血流量接近休克前水平,但显著低于rHb2.0和HSA组(P<0.01)。重组血红蛋白可恢复并维持MAP休克前水平60-90min,清蛋白只能维持30min。动脉及肠系膜上静脉血气分析显示两种重组血红蛋白治疗效果相似,显著高于HSA组(P<0.05)。结论 重组血红蛋白治疗失血性休克效果优于清蛋白,rHb 2.0是较理想的血液替代品。Objective To assess the therapeutic effects of two types of recombinant hemoglobin (rHb) on hemorrhagic shock. Methods Twenty-four male Wistar rats weighing 300-350 g were randomly divided into 3 equal groups: control group received 13.4 % human serum albumin (HSA) for resuscitation; rHb 1.1 group received rHb 1.1; rHb 2.0 guoup received rHb 2.0. The animals were anesthetized with intraperitoneal ketamine 90 mg·kg-1 , midazolam 0.5 mg·kg-1 and atropine 0.05 mg·kg-1 , tracheotomized and mechanically ventilated. PETCO2 was maintained at 35-45 mm Hg. Hemorrhagic shock was induced by withdrawing blood from femoral artery. MAP was maintained at 40 mm Hg for 45 rain before resuscitation. Direct arterial MAP and HR were continuously monitored. Blood flow in superior mesenteric artery ( QSMA ) and gases of blood from femoral artery and superior mesenteric vein were measured before hemorrhagic shock (T0), at the end of 45 min shock (T1) and 30, 60, 90, 120 min after resuscitation (T2-5 ) .Results In rHB 1.1 group 30 min after resuscitation MAP was increased significantly as compared with the baseline MAP (T0) and the MAP in the other two groups (P < 0.05) . QSMA in rHb 1.1 group was close to the baseline level (T0 ) but significantly lower than that in control group and rHb 2.0 group at all time points after resuscitation (T2,5), P < 0.01. Intravenous rHb infusion could raise MAP to baseline level and MAP could be maintained at this level for 60-90 min, whereas HSA could maintain MAP at baseline level for only 30 min. Blood gas analysis and QSMA showed that both rHb 1.1 and rHb 2.0 had similar therapeutic effects on hemorrhagic shock and were better than HSA ( P < 0.05 ) . Conclusion The therapeutic effects of rHb are better than HSA in the resuscitation of hemorrhagic shock. rHb 2.0 is a better blood substitute.

关 键 词：失血性休克 重组血红蛋白 清蛋白 血液动力学 动脉血气分析 

分 类 号：R614[医药卫生—麻醉学]