中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2008年
7期
717-723
,共7页
施小燕%李雷清%邵菊芳%张小刚%秦广明%周岩
施小燕%李雷清%邵菊芳%張小剛%秦廣明%週巖
시소연%리뢰청%소국방%장소강%진엄명%주암
失血性休克%缺血.再灌注%自由基%依达拉奉
失血性休剋%缺血.再灌註%自由基%依達拉奉
실혈성휴극%결혈.재관주%자유기%의체랍봉
Haemorrhagic shock%Ischaemia-reperfusion%Free radical%Edaravone
目的 观察兔失血性休克再灌注过程中血浆丙二醛(MDA)、一氧化氮(NO)与超氧化物岐化酶(SOD)水平的动态变化,以及肺脏、肾脏病理改变;并探讨依达拉奉的保护作用.方法 29只家兔全身肝素化后随机分为三组:假手术组(C组,n=7)、失血性休克再灌注组(I/R组,n = 10)和依达拉奉保护组(L/R-edaravone组,n=12).后两组制作失血性休克再灌注模型,在10 min内通过左股动脉放血,维持平均动脉压(MAP)40 mmHg达到60 min.I/R-edar-avone组静脉应用依达拉奉.然后开始复苏,要求在60 min内回输全部失血和等量生理盐水,使MAP维持在失血前70%以上.休克后10 h L/R-edaravone组静脉再次应用依达拉奉.在复苏后20 h处死所有家兔,同时取所有兔的右肺部分组织和右肾部分组织作病理检查.分别测休克前、休克1 h、再灌注后1 h、5 h及20 h血浆MDA、SOD、NO含量.结果 休克前三组动物血浆MDA、NO及SOD含量均无显著统计学差异.休克后I/R组家兔血浆MOA(5.35±0.29)μmol/L及NO(27.75±2.88) μmol/L水平均较C组的[(4.44±0.59)μmol/L,(25.01±4.95) μmol/L]要高,而I/R组的SOD水平(194.58±14.42)U/ml 较C组(210.86±24.54)U/ml要低(P均<0.01).复苏后20 h这些变化更加明显,I/R组MDA和NO水平持续增加[(5.69±0.24)μmol/L,(28.01±3.10)μmol/L,P<0.05],而SOD水平继续下降[(151.83±9.36)U/ml,P<0.05].与I/R组比较,I/R-edaravone组的MDA水平显著降低[(3.48±0.23) μmol/L,P<0.01],SOD水平明显升高[(195.10±11.87)U/ml,P<0.01].病理检查提示依达拉奉可以减轻肺脏和肾脏病理损害.结论 依达拉奉通过清除自由基,有效减轻失血性休克再灌注过程中重要脏器的损害.
目的 觀察兔失血性休剋再灌註過程中血漿丙二醛(MDA)、一氧化氮(NO)與超氧化物岐化酶(SOD)水平的動態變化,以及肺髒、腎髒病理改變;併探討依達拉奉的保護作用.方法 29隻傢兔全身肝素化後隨機分為三組:假手術組(C組,n=7)、失血性休剋再灌註組(I/R組,n = 10)和依達拉奉保護組(L/R-edaravone組,n=12).後兩組製作失血性休剋再灌註模型,在10 min內通過左股動脈放血,維持平均動脈壓(MAP)40 mmHg達到60 min.I/R-edar-avone組靜脈應用依達拉奉.然後開始複囌,要求在60 min內迴輸全部失血和等量生理鹽水,使MAP維持在失血前70%以上.休剋後10 h L/R-edaravone組靜脈再次應用依達拉奉.在複囌後20 h處死所有傢兔,同時取所有兔的右肺部分組織和右腎部分組織作病理檢查.分彆測休剋前、休剋1 h、再灌註後1 h、5 h及20 h血漿MDA、SOD、NO含量.結果 休剋前三組動物血漿MDA、NO及SOD含量均無顯著統計學差異.休剋後I/R組傢兔血漿MOA(5.35±0.29)μmol/L及NO(27.75±2.88) μmol/L水平均較C組的[(4.44±0.59)μmol/L,(25.01±4.95) μmol/L]要高,而I/R組的SOD水平(194.58±14.42)U/ml 較C組(210.86±24.54)U/ml要低(P均<0.01).複囌後20 h這些變化更加明顯,I/R組MDA和NO水平持續增加[(5.69±0.24)μmol/L,(28.01±3.10)μmol/L,P<0.05],而SOD水平繼續下降[(151.83±9.36)U/ml,P<0.05].與I/R組比較,I/R-edaravone組的MDA水平顯著降低[(3.48±0.23) μmol/L,P<0.01],SOD水平明顯升高[(195.10±11.87)U/ml,P<0.01].病理檢查提示依達拉奉可以減輕肺髒和腎髒病理損害.結論 依達拉奉通過清除自由基,有效減輕失血性休剋再灌註過程中重要髒器的損害.
목적 관찰토실혈성휴극재관주과정중혈장병이철(MDA)、일양화담(NO)여초양화물기화매(SOD)수평적동태변화,이급폐장、신장병리개변;병탐토의체랍봉적보호작용.방법 29지가토전신간소화후수궤분위삼조:가수술조(C조,n=7)、실혈성휴극재관주조(I/R조,n = 10)화의체랍봉보호조(L/R-edaravone조,n=12).후량조제작실혈성휴극재관주모형,재10 min내통과좌고동맥방혈,유지평균동맥압(MAP)40 mmHg체도60 min.I/R-edar-avone조정맥응용의체랍봉.연후개시복소,요구재60 min내회수전부실혈화등량생리염수,사MAP유지재실혈전70%이상.휴극후10 h L/R-edaravone조정맥재차응용의체랍봉.재복소후20 h처사소유가토,동시취소유토적우폐부분조직화우신부분조직작병리검사.분별측휴극전、휴극1 h、재관주후1 h、5 h급20 h혈장MDA、SOD、NO함량.결과 휴극전삼조동물혈장MDA、NO급SOD함량균무현저통계학차이.휴극후I/R조가토혈장MOA(5.35±0.29)μmol/L급NO(27.75±2.88) μmol/L수평균교C조적[(4.44±0.59)μmol/L,(25.01±4.95) μmol/L]요고,이I/R조적SOD수평(194.58±14.42)U/ml 교C조(210.86±24.54)U/ml요저(P균<0.01).복소후20 h저사변화경가명현,I/R조MDA화NO수평지속증가[(5.69±0.24)μmol/L,(28.01±3.10)μmol/L,P<0.05],이SOD수평계속하강[(151.83±9.36)U/ml,P<0.05].여I/R조비교,I/R-edaravone조적MDA수평현저강저[(3.48±0.23) μmol/L,P<0.01],SOD수평명현승고[(195.10±11.87)U/ml,P<0.01].병리검사제시의체랍봉가이감경폐장화신장병리손해.결론 의체랍봉통과청제자유기,유효감경실혈성휴극재관주과정중중요장기적손해.
Objective To investigate the dynamic changes of MDA, NO, SOD and pathologic changes of the lung and kidneyduring repefusion after haemorrhagic shock in rabbits, and to study the protective effects of edaravone during thecourse.Method Totally 29 beparinized (3 mg/kg) rabbits were randomly divided into three groups:tho sham-operatedcontrol group (group C, n = 7), the haemorrhagic shock group (group I/R, n = 10), and the haemorrhagicshock group with edaravone infusion (group I/R-edaravone, n = 12). Rabbits in the latter two groups were bledfrom left arteria cmralis in 10 minutes with MAP maintained at 40 mmHg for 60 minutes, and then group I/R-edar-avone was given edaravone intravenously. After that, resuscitation began:all blood loss was replaced with normalsaline within 60 minutes with MAP at the end ≥ 70% MAP before haemorrhagic shock. Edaravone was reinjectedat 10 hours after shock.All rabbits were killed at 20 h after reperfusion.Plasma nitric oxide(NO), malonyldialde-hyde (MDA) and superoxide dismutase(SOD) in every group were measured before shock,60 minutes after shockaad 1 h, 5 h and 20 h after reperfusien. Part of the right lung and the right kidney tissues were taken from everyrabbit for pathologic examnation after sacrifice.Results There was no significant difference in MDA,NO aad SOD among three groups before shock. A higherlevel of MDA (5.35±0.29 μmol/L), NO(27.75 ±2.88 μmol/L)and lower serum concentration of SOD(194.58±14.42U/ml)could be found in group I/R during haemorrhagic shock,as compared to group C(4.44±0.59 μmol/L,25.01±4.95μmol/L,210.86±24.54U/ml,respectively,P<0.01).At 20 hours after resuscitation,MDA and NO contents continued to increase(5.69±0.24 μmol/L and 28.01±3.10 μmol/L respectively,P<0.05)while SOD contents kept decreasing(151.83±9.36 U/ml,P<0.05)in group I/R.Comparing to group I/R,group I/R-edaravone had significant lower level of MDA(3.48±0.23 μmol/L,P<0.01)and higher concentration of SOD(195.10±11.87U/ml,P<0.01).Edaravone attenuated the pathologic changes in the lung and kidney.Conclusions Edaravone could effectively protect vital organs from reperfusion injury caused by free radicals following haemorrhagic shock by reducing plasma levels of MDA,NO and increasing levels of SOD.
