中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2010年
1期
47-51
,共5页
刘骏峰%平易%谢琼红%张家瑛%尤莉%钟建泳%梁伟民%李一%陈波斌%顾勇%林善锬%丁峰
劉駿峰%平易%謝瓊紅%張傢瑛%尤莉%鐘建泳%樑偉民%李一%陳波斌%顧勇%林善錟%丁峰
류준봉%평역%사경홍%장가영%우리%종건영%량위민%리일%진파빈%고용%림선담%정봉
脓毒血症%内皮细胞生物反应器%血流动力学
膿毒血癥%內皮細胞生物反應器%血流動力學
농독혈증%내피세포생물반응기%혈류동역학
Sepsis%Endothelial bioreaetor device%Hemodynamics
目的 观察内皮细胞生物反应器对猪脓毒血症的治疗作用.方法 健康杂交家猪静滴内毒素(LPS,0.25 mg·kg~(-1))建立脓毒症模型,随机(随机数字法)接受内皮细胞生物反应器(EBR组)和假性循环(对照组)治疗(每组n=6).在IPS注射后立即进行体外循环,血流量为30 mL/min,EBR组的血流经过内皮细胞生物反应器内腔后由颈内静脉回流全体内;假性循环组的血流经过同样大小的生物反应器,但不含有内皮细胞.同时记录每一头猪的生存时间.在实验开始前和开始后的每个小时分别观察实验动物的血流动力学指标、血液生化、血浆炎症因子、内皮素-1(ET-1)和血管性血友病因子(vWF)等.在记录实验猪的生存时间后立即取肺组织标本进行肺脏病理检查和肺损伤分数的计算.采用SPSS 11.5统计软件对时间依赖的血流动力学和细胞因子数据进行重复测量方差分析,生存时间则使用Student's t-tests进行检验.结果 在注射IPS后两组的平均动脉压(MAP)都开始显著下降,但EBR组2h后MAP下降速度显著慢于对照组,两组差异具有统计学意义(P<0.05).EBR组的ET-1在治疗开始时有轻度下降,而对照组的ET-1则持续地升高,两组之间的差异具有统计学意义(P<0.01),vWF在两组的变化都是先升高,并在实验6 h时回复到基础水平,但EBR组的升高幅度低于对照组(P<0.05).肺损伤分数在EBR组显著低于对照组[(6.1±0.9)vs.(8.2±1.0),P<0.05].实验结束时EBR组和对照组的生存时间分别为[(6.7±1.32)h vs.(5.2±0.61)h,P<0.01].结论 内皮细胞生物反应器不仅能够改善猪脓毒血症的血流动力学,而且能够维持重要脏器的功能,使得实验动物的存活时间延长.
目的 觀察內皮細胞生物反應器對豬膿毒血癥的治療作用.方法 健康雜交傢豬靜滴內毒素(LPS,0.25 mg·kg~(-1))建立膿毒癥模型,隨機(隨機數字法)接受內皮細胞生物反應器(EBR組)和假性循環(對照組)治療(每組n=6).在IPS註射後立即進行體外循環,血流量為30 mL/min,EBR組的血流經過內皮細胞生物反應器內腔後由頸內靜脈迴流全體內;假性循環組的血流經過同樣大小的生物反應器,但不含有內皮細胞.同時記錄每一頭豬的生存時間.在實驗開始前和開始後的每箇小時分彆觀察實驗動物的血流動力學指標、血液生化、血漿炎癥因子、內皮素-1(ET-1)和血管性血友病因子(vWF)等.在記錄實驗豬的生存時間後立即取肺組織標本進行肺髒病理檢查和肺損傷分數的計算.採用SPSS 11.5統計軟件對時間依賴的血流動力學和細胞因子數據進行重複測量方差分析,生存時間則使用Student's t-tests進行檢驗.結果 在註射IPS後兩組的平均動脈壓(MAP)都開始顯著下降,但EBR組2h後MAP下降速度顯著慢于對照組,兩組差異具有統計學意義(P<0.05).EBR組的ET-1在治療開始時有輕度下降,而對照組的ET-1則持續地升高,兩組之間的差異具有統計學意義(P<0.01),vWF在兩組的變化都是先升高,併在實驗6 h時迴複到基礎水平,但EBR組的升高幅度低于對照組(P<0.05).肺損傷分數在EBR組顯著低于對照組[(6.1±0.9)vs.(8.2±1.0),P<0.05].實驗結束時EBR組和對照組的生存時間分彆為[(6.7±1.32)h vs.(5.2±0.61)h,P<0.01].結論 內皮細胞生物反應器不僅能夠改善豬膿毒血癥的血流動力學,而且能夠維持重要髒器的功能,使得實驗動物的存活時間延長.
목적 관찰내피세포생물반응기대저농독혈증적치료작용.방법 건강잡교가저정적내독소(LPS,0.25 mg·kg~(-1))건립농독증모형,수궤(수궤수자법)접수내피세포생물반응기(EBR조)화가성순배(대조조)치료(매조n=6).재IPS주사후립즉진행체외순배,혈류량위30 mL/min,EBR조적혈류경과내피세포생물반응기내강후유경내정맥회류전체내;가성순배조적혈류경과동양대소적생물반응기,단불함유내피세포.동시기록매일두저적생존시간.재실험개시전화개시후적매개소시분별관찰실험동물적혈류동역학지표、혈액생화、혈장염증인자、내피소-1(ET-1)화혈관성혈우병인자(vWF)등.재기록실험저적생존시간후립즉취폐조직표본진행폐장병리검사화폐손상분수적계산.채용SPSS 11.5통계연건대시간의뢰적혈류동역학화세포인자수거진행중복측량방차분석,생존시간칙사용Student's t-tests진행검험.결과 재주사IPS후량조적평균동맥압(MAP)도개시현저하강,단EBR조2h후MAP하강속도현저만우대조조,량조차이구유통계학의의(P<0.05).EBR조적ET-1재치료개시시유경도하강,이대조조적ET-1칙지속지승고,량조지간적차이구유통계학의의(P<0.01),vWF재량조적변화도시선승고,병재실험6 h시회복도기출수평,단EBR조적승고폭도저우대조조(P<0.05).폐손상분수재EBR조현저저우대조조[(6.1±0.9)vs.(8.2±1.0),P<0.05].실험결속시EBR조화대조조적생존시간분별위[(6.7±1.32)h vs.(5.2±0.61)h,P<0.01].결론 내피세포생물반응기불부능구개선저농독혈증적혈류동역학,이차능구유지중요장기적공능,사득실험동물적존활시간연장.
Objective To investigate the role of endothelial bioreacter device in sepsis porcine model.Method Sepsis porcine model was induced gy established endotoxin (LPS,0.25 mg·kg~(-1)) in healthy hybrid swines. The animals were randomly divided(random number) into endothelial bioreactor device group(EBR group) and sham circulation group( Sham group)( n = 6, respectively). After the infusion of endotoxin, extracorporeal circulation was started with the blood flow of 30 mL/min. The blood went through the endothelial bioreactor, then went back to the body via internal jugular vein in the EBR group. The bioreactor with the same size and without endothelial cells(ECs) was used in the sham group. Hemodynamic variables, blood biochemistry, inflammatory markers, Endothelin-1(ET-11) and yon Willebrand Factor(vWF) were examined just before and every hour after the injection. When the survival time of the animals was recorded,the animals were sacrificed to calculate the lung injury score. The time-dependent hemodynamics and cytokine data were compared between groups by repeated measurement ANOVA .Student's t -test was used to analyze the survival time. Results The mean artetial blood pressure (MAP) remarkably decreased in both groups after LPS injection, while the decreasing rate in EBR group was significantly lower than that in control group after 2 hours( P < 0.05). The ET- 1 level in EBR group increased after a slight decrease at the beginning, while that in the sham group went on increasing(P<0.01). The vWF levels increased first, then returned to the baseline in the sixth hour in both groups, while the change in EBR group was significantly less than that in the sham group(P<0.05). The Lung Injury Score in EBR-treated group was significantly lower than that in the sham group(6.1 ± 0.9 vs. 8.2 ± 1. 0, P < 0.05). These physiologic and biochemical alterations were associated with a significant advantage to the survivals in the EBR group when compared with the control sham group(6.7 ± 1.32 vs. 5.2 ± 0.61 h, P < 0.01 ). Conclusions Timely intervention in endotoxin shock with EC therapy by using tissue-engineered bioreactor may improve cardiovascular performance and alter the natural course of this disease process, probably via modulating ioflammation and coagulation cascades.
