中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2012年
4期
233-236
,共4页
缺血/再灌注损伤%血必净注射液%丙二醛%白细胞介素-1β%肿瘤坏死因子-α%兔
缺血/再灌註損傷%血必淨註射液%丙二醛%白細胞介素-1β%腫瘤壞死因子-α%兔
결혈/재관주손상%혈필정주사액%병이철%백세포개소-1β%종류배사인자-α%토
Ischemia/reperfusion injury%Xuebijing injection%Malondialdehyde%lnterleukin- 1 β%Tumor necrosis factor-α%Rabbit
目的 探讨家兔缺血/再灌注(I/R)损伤模型建立后血液中丙二醛(MDA)、白细胞介素-1β(IL-1p)、肿瘤坏死因子-α(TNF-α)、天冬氨酸转氨酶(AST)、肌酐(Cr)的变化,以及血必净注射液对急性I/R损伤的肝肾保护作用.方法 清洁级家兔60只,按随机数字表法分为6组:正常组,假手术组行同侧股动脉部位皮肤切开缝合,模型组以及血必净低、中、高剂量治疗组;建立I/R损伤模型(股动脉缺血4h后再通)后即刻及12、36、60h分别从耳缘静脉注射2ml/kg生理盐水或0.33、0.66、1.32 g/kg血必净注射液.各组于术后6、12、24及72h分别抽血检测血清中MDA、IL-1β、TNF-α、AST、Cr.结果 模型组术后各时问点MDA、IL-1 β、TNF-α及术后72 h AST、Cr均显著高于正常组和假手术组.与模型组比较,血必净各组随剂量增加各指标依次降低,血必净高剂量组6、12、24、72 h血清MDA( μmol/L)、IL-1 β(ng/L)和TNF-α(μg/L)均明显降低(MDA:9.74±3.71比12.35±4.64,11.26 ±4.14比12.82±3.85,9.72±2.25 比 13.30 ±2.83,9.12 ±2.72比13.10±2.72;IL-1β:83.49±12.79比100.09±17.53,85.10±11.75比102.64±19.64,75.97±11.29比99.24±14.62,81.96±14.81比99.59±12.05;TNF-α:8.95±1.13比9.94±1.29,8.79±1.80比9.56±0.89,8.27±1.83比9.51±1.32,7.23±1.39比9.23±1.05,P＜ 0.05或P＜0.01);24h、72 h时血必净低、中、高剂量组血清AST(U/L)和Cr( μmol/L)均显著降低(AST 24 h:24.00±1.27、23.80±1.11、22.90±1.65比39.50±1.73,72 h:32.15±1.95、32.90±1.77、32.25±2.25比52.86±2.43;Cr 24 h:273.78±17.04、267.07±19.59、265.25±15.59比347.60±18.83,72 h:437.38±18.48,343.77±16.79、351.48±20.22比437.50±19.86,均P＜0.01).结论 I/R损伤可导致明显的全身炎症反应和氧自由基损伤,高剂量血必净注射液可以显著减轻全身炎症反应,降低血清MDA水平,低、中、高剂最血必净注射液治疗均能减少肝肾损伤,具有保护肝肾功能的作用.
目的 探討傢兔缺血/再灌註(I/R)損傷模型建立後血液中丙二醛(MDA)、白細胞介素-1β(IL-1p)、腫瘤壞死因子-α(TNF-α)、天鼕氨痠轉氨酶(AST)、肌酐(Cr)的變化,以及血必淨註射液對急性I/R損傷的肝腎保護作用.方法 清潔級傢兔60隻,按隨機數字錶法分為6組:正常組,假手術組行同側股動脈部位皮膚切開縫閤,模型組以及血必淨低、中、高劑量治療組;建立I/R損傷模型(股動脈缺血4h後再通)後即刻及12、36、60h分彆從耳緣靜脈註射2ml/kg生理鹽水或0.33、0.66、1.32 g/kg血必淨註射液.各組于術後6、12、24及72h分彆抽血檢測血清中MDA、IL-1β、TNF-α、AST、Cr.結果 模型組術後各時問點MDA、IL-1 β、TNF-α及術後72 h AST、Cr均顯著高于正常組和假手術組.與模型組比較,血必淨各組隨劑量增加各指標依次降低,血必淨高劑量組6、12、24、72 h血清MDA( μmol/L)、IL-1 β(ng/L)和TNF-α(μg/L)均明顯降低(MDA:9.74±3.71比12.35±4.64,11.26 ±4.14比12.82±3.85,9.72±2.25 比 13.30 ±2.83,9.12 ±2.72比13.10±2.72;IL-1β:83.49±12.79比100.09±17.53,85.10±11.75比102.64±19.64,75.97±11.29比99.24±14.62,81.96±14.81比99.59±12.05;TNF-α:8.95±1.13比9.94±1.29,8.79±1.80比9.56±0.89,8.27±1.83比9.51±1.32,7.23±1.39比9.23±1.05,P＜ 0.05或P＜0.01);24h、72 h時血必淨低、中、高劑量組血清AST(U/L)和Cr( μmol/L)均顯著降低(AST 24 h:24.00±1.27、23.80±1.11、22.90±1.65比39.50±1.73,72 h:32.15±1.95、32.90±1.77、32.25±2.25比52.86±2.43;Cr 24 h:273.78±17.04、267.07±19.59、265.25±15.59比347.60±18.83,72 h:437.38±18.48,343.77±16.79、351.48±20.22比437.50±19.86,均P＜0.01).結論 I/R損傷可導緻明顯的全身炎癥反應和氧自由基損傷,高劑量血必淨註射液可以顯著減輕全身炎癥反應,降低血清MDA水平,低、中、高劑最血必淨註射液治療均能減少肝腎損傷,具有保護肝腎功能的作用.
목적 탐토가토결혈/재관주(I/R)손상모형건립후혈액중병이철(MDA)、백세포개소-1β(IL-1p)、종류배사인자-α(TNF-α)、천동안산전안매(AST)、기항(Cr)적변화,이급혈필정주사액대급성I/R손상적간신보호작용.방법 청길급가토60지,안수궤수자표법분위6조:정상조,가수술조행동측고동맥부위피부절개봉합,모형조이급혈필정저、중、고제량치료조;건립I/R손상모형(고동맥결혈4h후재통)후즉각급12、36、60h분별종이연정맥주사2ml/kg생리염수혹0.33、0.66、1.32 g/kg혈필정주사액.각조우술후6、12、24급72h분별추혈검측혈청중MDA、IL-1β、TNF-α、AST、Cr.결과 모형조술후각시문점MDA、IL-1 β、TNF-α급술후72 h AST、Cr균현저고우정상조화가수술조.여모형조비교,혈필정각조수제량증가각지표의차강저,혈필정고제량조6、12、24、72 h혈청MDA( μmol/L)、IL-1 β(ng/L)화TNF-α(μg/L)균명현강저(MDA:9.74±3.71비12.35±4.64,11.26 ±4.14비12.82±3.85,9.72±2.25 비 13.30 ±2.83,9.12 ±2.72비13.10±2.72;IL-1β:83.49±12.79비100.09±17.53,85.10±11.75비102.64±19.64,75.97±11.29비99.24±14.62,81.96±14.81비99.59±12.05;TNF-α:8.95±1.13비9.94±1.29,8.79±1.80비9.56±0.89,8.27±1.83비9.51±1.32,7.23±1.39비9.23±1.05,P＜ 0.05혹P＜0.01);24h、72 h시혈필정저、중、고제량조혈청AST(U/L)화Cr( μmol/L)균현저강저(AST 24 h:24.00±1.27、23.80±1.11、22.90±1.65비39.50±1.73,72 h:32.15±1.95、32.90±1.77、32.25±2.25비52.86±2.43;Cr 24 h:273.78±17.04、267.07±19.59、265.25±15.59비347.60±18.83,72 h:437.38±18.48,343.77±16.79、351.48±20.22비437.50±19.86,균P＜0.01).결론 I/R손상가도치명현적전신염증반응화양자유기손상,고제량혈필정주사액가이현저감경전신염증반응,강저혈청MDA수평,저、중、고제최혈필정주사액치료균능감소간신손상,구유보호간신공능적작용.
Objective To investigate the changes in serum malondialdehyde (MDA),interleukin-1 β (IL-1 β),tumor necrosis factor-α (TNF-α),aspartate aminotransferase (AST) and creatinine (Cr) after the reproduction of ischemia/reperfusion (I/R) injury model,and the protective effects of liver and kidney with Xuebijing injection on acute I/R injury in rabbits.Methods Sixty rabbits were divided into six groups with a random number:A,normal group; B,sham operated group; C,model group,and D,E,F groups (Xuebijing low,middle,high dosage treatment groups).I/R injury model was reproduced (after a 4-hour ischemia,the femoral vessels were reperfusion ).Physiological saline (2 ml/kg) or 0.33,0.66 and 1.32 g/kg Xuebijing injection were given at 0,12,36,60 hours after operation via ear vein.MDA,IL-1β,TNF-α,AST and Cr were determined at 6,12,24 and 72 hours after reperfusion in each group.Results MDA,IL-1β,TNF-α at different time points,AST and Cr at 72 hours after reperfusion in C group were significantly higher than those in A group and B group.Compared with the C group,the above indexes were gradually decreased with does-dependence,the values of MDA ( μmol/L ),IL- 1β ( ng/L ) and TNF-α (μg/L) in serum of group F at 6,12,24 and 72 hours after reperfusion were significantly lower (MDA:9.74 ± 3.71 vs.12.35 ±4.64,11.26 ± 4.14 vs.12.82 ± 3.85,9.72 ± 2.25 vs.13.30 ± 2.83,9.12 ± 2.72 vs.13.10 ± 2.72; IL-1β:83.49 ± 12.79 vs.100.09 ± 17.53,85.10 ± 11.75 vs.102.64 ± 19.64,75.97 ± 11.29 vs.99.24 ± 14.62,81.96 ± 14.81 vs.99.59 ± 12.05;TNF-α:8.95 ± 1.13 vs.9.94 ± 1.29,8.79 ± 1.80 vs.9.56 ± 0.89,8.27 ± 1.83 vs.9.51 ± 1.32,7.23 ± 1.39 vs.9.23 ±1.05,P＜0.05 or P＜ 0.01 ).The values of AST(U/L) and Cr (μmol/L) in serum of groups D,E and F at 24 hours and 72 bours after reperfusion were significantly lower (AST 24 hours:24.00 ± 1.27,23.80 ± 1.11,22.90 ± 1.65 vs.39.50 ± 1.73,72 hours:32.15 ± 1.95,32.90 ± 1.77,32.25 ± 2.25 vs.52.86 ± 2.43; Cr 24 hours:273.78 ± 17.04,267.07 ± 19.59,265.25 ± 15.59 vs.347.60 ± 18.83,72 hours:437.38 ± 18.48,343.77 ± 16.79,351.48 ± 20.22 vs.437.50 ± 19.86,all P＜0.01 ).Conclusions It is demonstrated that I/R injury could dramatically lead to systemic inflammatory response and oxygen free radical injury.Xuebijing injection in higher dosage can reduce the systemic inflammatory response significantly,and also MDA level in serum.Xuebijing injection in low dosage,middle dosage and high dosage can produce protective effects against the damages to liver and kidney function.
