中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2011年
12期
734-738
,共5页
林胜谋%王晨虹%周洲%盛超%林赛穆
林勝謀%王晨虹%週洲%盛超%林賽穆
림성모%왕신홍%주주%성초%림새목
产兔%失血性休克%肺损伤,急性%肿瘤坏死因子-a
產兔%失血性休剋%肺損傷,急性%腫瘤壞死因子-a
산토%실혈성휴극%폐손상,급성%종류배사인자-a
Postpartum rabbit%Hemorrhagic shock%Acute lung injury%Tumor necrosis factor-α
目的 探讨产兔和非孕兔失血性休克复苏后急性肺损伤的差异.方法 将18只新西兰兔按随机数字表法分为产兔组和非孕兔组,每组9只.采用颈动脉放血致失血性休克1h,乳酸林格液复苏持续3h建立失血性休克复苏模型.分别于产前期、产后期(休克前期,0h)、休克期末(1 h)、复苏期间(2.5 h)以及复苏期末(4 h)5个时间点采血测定肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)；复苏期持续3h后处死动物,取肺组织检测丙二醛(MDA)、超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、干/湿重比值(D/W),以及核转录因子-κB(NF-κB)活性和细胞间黏附分子-1(ICAM-1)mRNA表达.结果 产兔产前期血清TNF-α(ng/L)、IL-10(ng/L)含量与非孕兔差异无统计学意义(TNF-α:87.6±6.8比83.2±5.3；IL-10:44.9±3.9比42.7±3.4,均P＞0.05)；休克前期TNF-α水平显著增高(102.5±8.1比87.6±6.8,P＜0.05).产兔与非孕兔休克1h后TNF-α、IL-10均升高；各复苏时期产兔TNF-α水平明显高于非孕兔(1 h:230.0±14.9比202.0±10.1,2.5 h:290.0±18.6比236.0±14.4,4 h:265.0±15.9比217.0±12.8,均P＜0.05),而IL-10水平明显低于非孕兔(1 h:104.3±6.9比135.0±7.8,2.5 h:146.8±9.4比178.3±11.7,4 h:126.0±7.9比165.8±9.6,均P＜0.05).休克复苏后产兔肺组织MDA、MPO、D/W比值、NF-κB活性和ICAM-1 mRNA表达均显著高于非孕兔[MDA(nmol/mg):52.6±5.9比39.4±4.7,MPO(U/mg):4.62±0.85比3.26±0.62,D/W比值:0.186±0.025比0.143±0.016,NF-κB(A值):0.89±0.27比0.46±0.15,ICAM-1mRNA:4.6±1.2比2.5±0.7,均P＜0.05]；而SOD(U/mg)水平较低(47.8±6.7比63.5±8.2,P＜0.05).结论 分娩可致产兔血清炎症因子TNF-α显著升高,失血性休克复苏后产兔出现肺组织炎症损伤较非孕兔更为严重,炎症因子的差异可能是导致休克复苏后炎症应答差异的原因之一.
目的 探討產兔和非孕兔失血性休剋複囌後急性肺損傷的差異.方法 將18隻新西蘭兔按隨機數字錶法分為產兔組和非孕兔組,每組9隻.採用頸動脈放血緻失血性休剋1h,乳痠林格液複囌持續3h建立失血性休剋複囌模型.分彆于產前期、產後期(休剋前期,0h)、休剋期末(1 h)、複囌期間(2.5 h)以及複囌期末(4 h)5箇時間點採血測定腫瘤壞死因子-α(TNF-α)、白細胞介素-10(IL-10)；複囌期持續3h後處死動物,取肺組織檢測丙二醛(MDA)、超氧化物歧化酶(SOD)、髓過氧化物酶(MPO)、榦/濕重比值(D/W),以及覈轉錄因子-κB(NF-κB)活性和細胞間黏附分子-1(ICAM-1)mRNA錶達.結果 產兔產前期血清TNF-α(ng/L)、IL-10(ng/L)含量與非孕兔差異無統計學意義(TNF-α:87.6±6.8比83.2±5.3；IL-10:44.9±3.9比42.7±3.4,均P＞0.05)；休剋前期TNF-α水平顯著增高(102.5±8.1比87.6±6.8,P＜0.05).產兔與非孕兔休剋1h後TNF-α、IL-10均升高；各複囌時期產兔TNF-α水平明顯高于非孕兔(1 h:230.0±14.9比202.0±10.1,2.5 h:290.0±18.6比236.0±14.4,4 h:265.0±15.9比217.0±12.8,均P＜0.05),而IL-10水平明顯低于非孕兔(1 h:104.3±6.9比135.0±7.8,2.5 h:146.8±9.4比178.3±11.7,4 h:126.0±7.9比165.8±9.6,均P＜0.05).休剋複囌後產兔肺組織MDA、MPO、D/W比值、NF-κB活性和ICAM-1 mRNA錶達均顯著高于非孕兔[MDA(nmol/mg):52.6±5.9比39.4±4.7,MPO(U/mg):4.62±0.85比3.26±0.62,D/W比值:0.186±0.025比0.143±0.016,NF-κB(A值):0.89±0.27比0.46±0.15,ICAM-1mRNA:4.6±1.2比2.5±0.7,均P＜0.05]；而SOD(U/mg)水平較低(47.8±6.7比63.5±8.2,P＜0.05).結論 分娩可緻產兔血清炎癥因子TNF-α顯著升高,失血性休剋複囌後產兔齣現肺組織炎癥損傷較非孕兔更為嚴重,炎癥因子的差異可能是導緻休剋複囌後炎癥應答差異的原因之一.
목적 탐토산토화비잉토실혈성휴극복소후급성폐손상적차이.방법 장18지신서란토안수궤수자표법분위산토조화비잉토조,매조9지.채용경동맥방혈치실혈성휴극1h,유산림격액복소지속3h건립실혈성휴극복소모형.분별우산전기、산후기(휴극전기,0h)、휴극기말(1 h)、복소기간(2.5 h)이급복소기말(4 h)5개시간점채혈측정종류배사인자-α(TNF-α)、백세포개소-10(IL-10)；복소기지속3h후처사동물,취폐조직검측병이철(MDA)、초양화물기화매(SOD)、수과양화물매(MPO)、간/습중비치(D/W),이급핵전록인자-κB(NF-κB)활성화세포간점부분자-1(ICAM-1)mRNA표체.결과 산토산전기혈청TNF-α(ng/L)、IL-10(ng/L)함량여비잉토차이무통계학의의(TNF-α:87.6±6.8비83.2±5.3；IL-10:44.9±3.9비42.7±3.4,균P＞0.05)；휴극전기TNF-α수평현저증고(102.5±8.1비87.6±6.8,P＜0.05).산토여비잉토휴극1h후TNF-α、IL-10균승고；각복소시기산토TNF-α수평명현고우비잉토(1 h:230.0±14.9비202.0±10.1,2.5 h:290.0±18.6비236.0±14.4,4 h:265.0±15.9비217.0±12.8,균P＜0.05),이IL-10수평명현저우비잉토(1 h:104.3±6.9비135.0±7.8,2.5 h:146.8±9.4비178.3±11.7,4 h:126.0±7.9비165.8±9.6,균P＜0.05).휴극복소후산토폐조직MDA、MPO、D/W비치、NF-κB활성화ICAM-1 mRNA표체균현저고우비잉토[MDA(nmol/mg):52.6±5.9비39.4±4.7,MPO(U/mg):4.62±0.85비3.26±0.62,D/W비치:0.186±0.025비0.143±0.016,NF-κB(A치):0.89±0.27비0.46±0.15,ICAM-1mRNA:4.6±1.2비2.5±0.7,균P＜0.05]；이SOD(U/mg)수평교저(47.8±6.7비63.5±8.2,P＜0.05).결론 분면가치산토혈청염증인자TNF-α현저승고,실혈성휴극복소후산토출현폐조직염증손상교비잉토경위엄중,염증인자적차이가능시도치휴극복소후염증응답차이적원인지일.
Objective To investigate the difference in the development of acute lung injury after hemorrhagic shock in postpartum and non-pregnant rabbits.Methods Hemorrhagic shock/resuscitation was produced on 9 pregnant New-Zealand rabbits postpartum(within 24 hours after giving birth)and 9 nonpregnant controls via carotid artery bleeding and perfusion(i.v.)of lactate Ringer solution for 3 hours.The serum level of cytokine tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)in the animals were measured at different time points.Lung tissue were taken 3 hours after resuscitation for the determination of malondialdehyde(MDA),the activity of superoxide dismutase(SOD),myeloperoxidase(MPO),dry/wet weight(D/W),nuclear factor-κB(NF-κB),and mRNA content of intercellular adhesion molecule-1 (ICAM-1).Results Serum TNF-α(ng/L)and IL-10(ng/L)in antepartum pregnant rabbits were not significantly different from non-pregnant rabbits(TNF-α:87.6±6.8 vs.83.2±5.3; IL-10:44.9±3.9 vs.42.7 ± 3.4,both P＞0.05).However,the serum TNF-α increased significantly after delivery(102.5 ± 8.1 vs.87.6±6.8,P＜0.05).TNF-α and IL-10 increased 1 hour after shock in both postpartum and nonpregnant rabbits.The serum TNF-α in postpartum rabbits was significant higher than non-pregnant rabbits in each resuscitation period(1 hour:230.0± 14.9 vs.202.0± 10.1,2.5 hours:290.0± 18.6 vs.236.0± 14.4,4 hours:265.0± 15.9 vs.217.0±12.8,all P＜0.05),meanwhile the serum IL-10 in postpartum animals was significantly lower than the non-pregnant controls(1 hour:104.3 ± 6.9 vs.135.0 ± 7.8,2.5 hours:146.8±9.4 vs.178.3±11.7,4 hours:126.0±7.9 vs.165.8±9.6,all P＜0.05).The value of MDA,MPO,D/W,NF-κB activity and ICAM-1 mRNA content in lung tissue of postpartum rabbits were all significant higher than non-pregnant rabbits after resuscitation[MDA(nmol/mg):52.6± 5.9 vs.39.4± 4.7,MPO(U/mg):4.62±0.85 vs.3.26±0.62,D/W:0.186±0.025 vs.0.143±0.016,NF-κB activity (A value):0.89±0.27 vs.0.46±0.15,ICAM-1mRNA:4.6±1.2 vs.2.5±0.7,allP＜0.05],but the activity of SOD(U/mg)was lower(47.8±6.7 vs.63.5±8.2,P＜0.05)in the controls after resucitation.Conclusions Delivery causes significant increase in serum TNF-a in pregnant rabbits.Inflammatory lung injury is more severe in postpartum rabbits after resuscitation from hemorrhagic shock,and the increased serum level of inflammatory mediators may be part of the mechanism for such difference.
