CAJ | 학술논문

目的评价小容量不同液体治疗对内毒素血症大鼠肾血流的影响.方法清洁级雄性SD大鼠30只,体重180～250 g,随机分为5组(n=6):对照组(C组)、内毒素血症组(LPS组)、7.5%高渗氯化钠溶液组(HS组)、羟乙基淀粉130/0.4溶液组(HES组)和高渗氯化钠羟乙基淀粉40溶液组(HSH组).LPS组、HS组、HES组和HSH组经左侧颈总动脉导管注射LPS 1 mg/kg,C组注射等容量生理盐水.30 min后,C组和LPS组注射生理盐水4 ml/kg;HS组、HES组和HSH组分别注射7.5%高渗氯化钠溶液、羟乙基淀粉130/0.4溶液或高渗氯化钠羟乙基淀粉40溶液4 ml/kg.于给予LPS前、给予LPS后30 min、液体治疗后10、30、60 min时进行左肾脏超声多普勒检测,记录左肾动脉的收缩峰值血流速度(Vmax)、舒张末期血流速度(Vmax)和阻力指数(RI).取肾组织,观察病理学结果.结果内毒素血症大鼠肾血流逐渐减弱,分布面积减小,肾皮质血流几乎消失,肾小管上皮细胞严重变性、崩解脱落、集合管内可见细胞碎片充塞,左肾段动脉Vmax和Vmin降低,RI升高(P＜0.01).与LPS组比较,HS组、HES组和HSH肾血流增强,Vmax和Vmin升高,RI降低,其中HSH组效果更佳(P＜0.01).结论小容量羟乙基淀粉130/0.4溶液、高渗盐水和高渗氯化钠羟乙基淀粉40溶液治疗可增强内毒素血症大鼠肾血流,改善肾脏微循环;高渗氯化钠羟乙基淀粉40溶液效果更佳.
목적 평개소용량불동액체치료대내독소혈증대서신혈류적영향.방법 청길급웅성SD대서30지,체중180～250 g,수궤분위5조(n=6):대조조(C조)、내독소혈증조(LPS조)、7.5%고삼록화납용액조(HS조)、간을기정분130/0.4용액조(HES조)화고삼록화납간을기정분40용액조(HSH조).LPS조、HS조、HES조화HSH조경좌측경총동맥도관주사LPS 1 mg/kg,C조주사등용량생리염수.30 min후,C조화LPS조주사생리염수4 ml/kg;HS조、HES조화HSH조분별주사7.5%고삼록화납용액、간을기정분130/0.4용액혹고삼록화납간을기정분40용액4 ml/kg.우급여LPS전、급여LPS후30 min、액체치료후10、30、60 min시진행좌신장초성다보륵검측,기록좌신동맥적수축봉치혈류속도(Vmax)、서장말기혈류속도(Vmax)화조력지수(RI).취신조직,관찰병이학결과.결과 내독소혈증대서신혈류축점감약,분포면적감소,신피질혈류궤호소실,신소관상피세포엄중변성、붕해탈락、집합관내가견세포쇄편충새,좌신단동맥Vmax화Vmin강저,RI승고(P＜0.01).여LPS조비교,HS조、HES조화HSH신혈류증강,Vmax화Vmin승고,RI강저,기중HSH조효과경가(P＜0.01).결론 소용량간을기정분130/0.4용액、고삼염수화고삼록화납간을기정분40용액치료가증강내독소혈증대서신혈류,개선신장미순배;고삼록화납간을기정분40용액효과경가.
Objective To evaluate the effects of therapy with small volume of different fluids on renal blood flow in endotoxemia rats.Methods Thirty parthogen-free SD rats weighing 180-250 g were randomly divided into 5 groups (n = 6 each):group Ⅰ control; group Ⅱ LPS; group Ⅲ LPS + 7.5 % hypertonic saline (HS);group Ⅳ LPS + hydrozyethly starch (HES) 130/0.4 and groupⅤ LPS + hypertonic saline plus hydroxyethly starch (HS-HES) 40. The animals were anesthetized with intraperitoneal 3% pentobarbital 40 mg/kg. Left carotid artery was cannulated for BP and HR monitoring and fluid administration. In groupⅡ-Ⅴ LPS 1 mg/kg was administered via arterial cannula. In group Ⅲ, Ⅳ and V 4 ml/kg of 7.5% HS, HES 130/0.4 AND HS-HES 40 were administered via arterial cannula respectively at 30 min after LPS administration.In groupⅠ and Ⅱ normal saline 4 ml/kg was given insteadt. Renal blood flow was measured with Doppler ultrasound before LPS (T1 ,baseline), at 30 min after LPS (T2), 10, 30 and 60 min after fluid therapy (T3, T4, T5). The animals were then sacrificed and both kidneys were removed for microscopic examination with light microscope. Results Renal blood flow was significantly decreased and was significantly recovered to some extent by therapy with different fluids especially with HS-HES 40 in group Ⅴ. Conclusion Therapy with small volume of HS,HES or HS-HES could increase renal blood flow and inprove renal microcirculation especially HS-HES.