CAJ | 학술논문

目的探讨胎羊内注射内毒素(LPS)后的静脉导管血流动力学变化及其与胎羊炎性介质变化的关系.方法 10只中晚孕山羊分为两组(实验组和对照组各5只),实验组于妊娠120～130 d行超声引导下胎羊脐静脉或脐-门静脉窦穿刺术,注射LPS(Escherichia coli O111:B5;L1885)约10μg/kg胎羊质量,对照组注射等量生理盐水.并分别于注射LPS前(0.5 h)、注射LPS后1 h、3 h、6 h应用彩色多普勒血流显像检测静脉导管血流频谱变化.同时抽取脐静脉血,用ELISA方法检测TNF-α、IL-6含量,并评价TNF-α、IL-6与静脉导管血流参数之间的相关性.结果实验组给药后静脉导管搏动指数(DVPI)、心室收缩期峰值速度(S)、心室舒张期峰值流速(D)、血流量(DVQ)、静脉导管指数(DVI)、心室收缩期峰值速度/心房收缩期峰值流速(S/A)、(S-A)/D随给药时间升高,并且高于对照组(均P＜0.05);心房收缩期峰值流速(A波)下降,并且低于对照组(P＜0.05);静脉导管峡部的内径(DVD)无明显变化.实验组DVPI与血清IL-6、TNF-α呈正相关(P均＜0.05);实验组A波值与血清IL-6、TNF-α呈负相关(均P＜0.05);S波、DVI、D波、DVQ、S/A、(S-A)/D与血清IL-6呈正相关(均P＜0.05),与TNF-α无明显相关(均P＞0.05);静脉导管峡部内径与血清IL-6、TNF-α均无明显相关.结论 DVPI、A值可能成为预测胎儿全身炎症反应综合征简便而有效的指标.
목적 탐토태양내주사내독소(LPS)후적정맥도관혈류동역학변화급기여태양염성개질변화적관계.방법 10지중만잉산양분위량조(실험조화대조조각5지),실험조우임신120～130 d행초성인도하태양제정맥혹제-문정맥두천자술,주사LPS(Escherichia coli O111:B5;L1885)약10μg/kg태양질량,대조조주사등량생리염수.병분별우주사LPS전(0.5 h)、주사LPS후1 h、3 h、6 h응용채색다보륵혈류현상검측정맥도관혈류빈보변화.동시추취제정맥혈,용ELISA방법검측TNF-α、IL-6함량,병평개TNF-α、IL-6여정맥도관혈류삼수지간적상관성.결과 실험조급약후정맥도관박동지수(DVPI)、심실수축기봉치속도(S)、심실서장기봉치류속(D)、혈류량(DVQ)、정맥도관지수(DVI)、심실수축기봉치속도/심방수축기봉치류속(S/A)、(S-A)/D수급약시간승고,병차고우대조조(균P＜0.05);심방수축기봉치류속(A파)하강,병차저우대조조(P＜0.05);정맥도관협부적내경(DVD)무명현변화.실험조DVPI여혈청IL-6、TNF-α정정상관(P균＜0.05);실험조A파치여혈청IL-6、TNF-α정부상관(균P＜0.05);S파、DVI、D파、DVQ、S/A、(S-A)/D여혈청IL-6정정상관(균P＜0.05),여TNF-α무명현상관(균P＞0.05);정맥도관협부내경여혈청IL-6、TNF-α균무명현상관.결론 DVPI、A치가능성위예측태인전신염증반응종합정간편이유효적지표.
Objective To study the hemodynamic characteristics of ductus venosus,and its relationship to inflammatory cytokines in ovine fetus with systemic inflammatory response syndrome.Methods Ten near-term fetal sheep radomly divided into two groups.Five of them were in experimental group,and five of them were in control group.All of the animals underwent abdominal cordocentesis guided by ultrasound at the term of 120-130 days,with a LPS injection at a dosage of 10 μg/kg of fetal weight in experimental group,and the same quantity of 0.9% NaCl solution in control.Doppler echocardiography were performed to determine hemodynamics changes of ductus venosus at 0.5 hour before the LPS injection,and at 1 hour,3 hours,6 hours after LPS injection.Meanwhile,fetal umbilical vein blood was sampled for ELISA essay of serum TNF-α and IL-6 at each of the above time points.Results In experimental group,the ductus venosus waveform PI values(DVPI),maximum velocity during cardiac ventricle systole(S)and during cardiac ventricle diastole(D),ductus venosus index(DVI),ductus venosus blood flow(DVQ),the ratio of S and ductus venous maximum velocity during atrial contracton(S/A),(S-A)/D increased with the time after LPS injection,and still significantly increased as compared with the control animals(all P＜0.05).A decreased with the time after LPS injection,and still significantly changed as compared with the controls(P＜0.05).And the ductus venosus diameter(DVD)had not obvious change(P＞0.05).There were significantly positive correlations between DVPI and TNF-α,IL-6(all P＜0.05),negative corelations between A and TNF-α,IL-6(all P＜0.05),and positive correlations between S wave,DVI,DVQ,D wave,S/A,(S-A)/D and IL-6(all P＜0.05),but not obvious relationships between S wave,DVI,DVQ,D wave,S/A,(S-A)/D and TNF-a(all P＞0.05).Condusions DVPI and A might be easy and useful quantitative parameters in the evaluation of fetal systemic inflammatory respome syndrome with LPS injection.