CAJ | 학술논문

目的探讨不同液体限制性复苏对活动性出血休克大鼠血白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的影响.方法将健康SD大鼠随机分成对照组、乳酸钠林格液复苏组(晶体组)、羟乙基淀粉复苏组(胶体组)和晶胶液复苏组(晶胶组),各实验复苏组分别制作活动性出血休克模型,于休克前、休克后平均动脉压(MAP)为40 mmHg(1 mmHg =0.133kPa)维持30 min后(0时相)、MAP为60 mmHg维持30 min后(1时相)、MAP为80 mmHg维持60 min后(2时相)以及复苏成功24h后(3时相)分别取外周血,对照组只在实验前和3时相取血,各组均采用EHSA法测定血浆IL-6和TNF-α含量.结果各组大鼠休克前及休克开始复苏前(0时相)血浆中IL-6和TNF-α含量比较差异无统计学意义(P值均＞0.05).在复苏过程中,晶体组血IL-6和TNF-α的含量均呈现先升高再下降的趋势,3时相血IL-6和TNF-α含量较对照组升高,差异均有统计学意义(P值均＜0.05);胶体组和晶胶组在复苏过程中IL-6和TNF-α的含量均呈现持续下降的趋势,3时相血IL-6和TNF-α的含量均较对照组减低,差异均有统计学意义(P值均＜0.05);1时相、2时相和3时相晶胶组血IL-6和TNF-α的含量均较胶体组减低,差异均有统计学意义(P值均＜0.05).结论晶胶液比晶体液、胶体液能更好地抑制活动性出血休克大鼠的促炎介质释放,可能是一种相对较好的复苏液体.
목적 탐토불동액체한제성복소대활동성출혈휴극대서혈백세포개소-6(IL-6)화종류배사인자-α(TNF-α)적영향.방법 장건강SD대서수궤분성대조조、유산납림격액복소조(정체조)、간을기정분복소조(효체조)화정효액복소조(정효조),각실험복소조분별제작활동성출혈휴극모형,우휴극전、휴극후평균동맥압(MAP)위40 mmHg(1 mmHg =0.133kPa)유지30 min후(0시상)、MAP위60 mmHg유지30 min후(1시상)、MAP위80 mmHg유지60 min후(2시상)이급복소성공24h후(3시상)분별취외주혈,대조조지재실험전화3시상취혈,각조균채용EHSA법측정혈장IL-6화TNF-α함량.결과 각조대서휴극전급휴극개시복소전(0시상)혈장중IL-6화TNF-α함량비교차이무통계학의의(P치균＞0.05).재복소과정중,정체조혈IL-6화TNF-α적함량균정현선승고재하강적추세,3시상혈IL-6화TNF-α함량교대조조승고,차이균유통계학의의(P치균＜0.05);효체조화정효조재복소과정중IL-6화TNF-α적함량균정현지속하강적추세,3시상혈IL-6화TNF-α적함량균교대조조감저,차이균유통계학의의(P치균＜0.05);1시상、2시상화3시상정효조혈IL-6화TNF-α적함량균교효체조감저,차이균유통계학의의(P치균＜0.05).결론 정효액비정체액、효체액능경호지억제활동성출혈휴극대서적촉염개질석방,가능시일충상대교호적복소액체.
Objective To investigate the effect of different fluid restriction resuscitation on IL-6 and TNF-α in rats with hemorrhagic shock.Methods All the healthy SD rats were randomly divided into four groups,normal control group,sodium lactate Ringer's fluid resuscitation group(crystal group),hydroxyethyl starch resuscitation group(colloidal group) and crystal glue fluid resuscitation group(crystal gel group).The model of hemorrhagic shock was established in the experiment groups.Draw blood of rats in each experiment group at the time of before shock,MAP =40 mmHg maintain 30 min (0 time point),MAP =60 mmHg maintain 30 min(1 time point),MAP =80 mmHg maintain 60 min(2 time point),and 24 hours later after successful resuscitation (3 time point).The normal control group rats were taken blood only before the experiment and the 3 time point.Enzyme-linked immunosorbent assay was used to determine IL-6 and TNF-α contents in plasma.Results Before shock and the shock began to recover (MAP =40 mmHg maintain 30 min,namely 0 time point),the contents of IL-6 and TNF-α in plasma of each group showed no statistical significance (P ＞ 0.05).In the process of limited resuscitation,the content of IL-6 and TNF-α in crystal group increased firstly and then decreased.The contents of IL-6 and TNF-α in crystal group were higher than those of the control group at the 3 time point,the difference showed statistical significance (all P values ＜ 0.05).The content of IL-6 and TNF-α in colloidal group and crystal gel group showed a declining trend.The content of IL-6 and TNF-α in colloidal group and crystal gel group were lower than those of the control group at the 3 time point,the difference was statistical significance (all P values ＜ 0.05).The content of IL-6 and TNF-α in crystal gel group were lower than those of the colloidal group and at the 1 time point,2 time point and 3 time point,the difference was statistical significance (all P values ＜ 0.05).Conclusions In the process of limited resuscitation,crystal glue liquid can better inhibit the release of proinflammatory mediators.Crystal glue liquid may be a relatively better resuscitate liquid.