CAJ | 학술논문

目的：研究丙酮酸钠林格液对失血性休克复苏后脂质过氧化诱导的多脏器功能损害的保护作用。方法：采用动脉放血(放血量为全身血容量的45%)的方法制备大鼠失血性休克模型。54只 SD大鼠随机分为3组,每组18只动物。单纯失血组(RN组)休克后不予任何处理,乳酸钠林格液组(RL 组)和丙酮酸钠林格液组(RP组)于休克1 h后分别补充3倍失血量的乳酸钠林格液或丙酮酸钠林格液。PICCO心肺容量监护仪监测失血前20 min(T-20),失血即刻(T0),失血后60、120、180、240、300、360 min(T60、T120、T180、T240、T300、T360)时的平均动脉压(MAP),检测各时间点血浆铜-锌超氧化物歧化酶(Cu2+-Zn2+-SOD)活性及丙二醛(MDA)含量；实验终点取心脏、肺脏、肝脏、肾脏、空肠组织,测定组织内MDA、氧化型和还原型谷胱甘肽、谷胱甘肽过氧化物酶、谷胱甘肽还原酶、过氧化氢酶水平,烘干前后的组织称重,计算组织含水率的变化；实验终点取动脉血,测定肌酸激酶同工酶(CK-MB)、动脉血氧分压(PaO2)、丙氨酸转氨酶(ALT)、二胺氧化酶(DAO)和血肌酐(Cr)变化。结果：T120开始, RL组和RP组MAP较RN组明显升高(P<0.05),T300~T360,RP组 MAP较 RL组明显升高(P<0.05)。T120~T360,RP 组 Cu2+-Zn2+-SOD 活性比 RN 组显著升高,但和 RL 组无明显差别；T180~T360,RP 组血浆中MDA水平显著低于 RL组(P<0.05)。RP组复苏后心、肺、肝和空肠组织内 MDA、氧化型谷胱甘肽含量较 RL组明显降低(P<0.05),还原型谷胱甘肽较 RL组明显升高(P<0.05)；RP 组复苏后心、肝和空肠组织内谷胱甘肽过氧化物酶含量较 RL明显降低(P<0.05),谷胱甘肽还原酶较 RL组明显升高(P<0.05)；RP 组脏器功能和组织含水率均较 RL组改善更明显。结论：丙酮酸钠林格液复苏在减轻失血性休克后组织过氧化引起的多脏器功能损害和水肿方面的作用明显优于乳酸钠林格液,有助于失血性休克后内脏过氧化损伤及并发症的防治。目的：研究丙酮痠鈉林格液對失血性休剋複囌後脂質過氧化誘導的多髒器功能損害的保護作用。方法：採用動脈放血(放血量為全身血容量的45%)的方法製備大鼠失血性休剋模型。54隻 SD大鼠隨機分為3組,每組18隻動物。單純失血組(RN組)休剋後不予任何處理,乳痠鈉林格液組(RL 組)和丙酮痠鈉林格液組(RP組)于休剋1 h後分彆補充3倍失血量的乳痠鈉林格液或丙酮痠鈉林格液。PICCO心肺容量鑑護儀鑑測失血前20 min(T-20),失血即刻(T0),失血後60、120、180、240、300、360 min(T60、T120、T180、T240、T300、T360)時的平均動脈壓(MAP),檢測各時間點血漿銅-鋅超氧化物歧化酶(Cu2+-Zn2+-SOD)活性及丙二醛(MDA)含量；實驗終點取心髒、肺髒、肝髒、腎髒、空腸組織,測定組織內MDA、氧化型和還原型穀胱甘肽、穀胱甘肽過氧化物酶、穀胱甘肽還原酶、過氧化氫酶水平,烘榦前後的組織稱重,計算組織含水率的變化；實驗終點取動脈血,測定肌痠激酶同工酶(CK-MB)、動脈血氧分壓(PaO2)、丙氨痠轉氨酶(ALT)、二胺氧化酶(DAO)和血肌酐(Cr)變化。結果：T120開始, RL組和RP組MAP較RN組明顯升高(P<0.05),T300~T360,RP組 MAP較 RL組明顯升高(P<0.05)。T120~T360,RP 組 Cu2+-Zn2+-SOD 活性比 RN 組顯著升高,但和 RL 組無明顯差彆；T180~T360,RP 組血漿中MDA水平顯著低于 RL組(P<0.05)。RP組複囌後心、肺、肝和空腸組織內 MDA、氧化型穀胱甘肽含量較 RL組明顯降低(P<0.05),還原型穀胱甘肽較 RL組明顯升高(P<0.05)；RP 組複囌後心、肝和空腸組織內穀胱甘肽過氧化物酶含量較 RL明顯降低(P<0.05),穀胱甘肽還原酶較 RL組明顯升高(P<0.05)；RP 組髒器功能和組織含水率均較 RL組改善更明顯。結論：丙酮痠鈉林格液複囌在減輕失血性休剋後組織過氧化引起的多髒器功能損害和水腫方麵的作用明顯優于乳痠鈉林格液,有助于失血性休剋後內髒過氧化損傷及併髮癥的防治。
목적：연구병동산납림격액대실혈성휴극복소후지질과양화유도적다장기공능손해적보호작용。방법：채용동맥방혈(방혈량위전신혈용량적45%)적방법제비대서실혈성휴극모형。54지 SD대서수궤분위3조,매조18지동물。단순실혈조(RN조)휴극후불여임하처리,유산납림격액조(RL 조)화병동산납림격액조(RP조)우휴극1 h후분별보충3배실혈량적유산납림격액혹병동산납림격액。PICCO심폐용량감호의감측실혈전20 min(T-20),실혈즉각(T0),실혈후60、120、180、240、300、360 min(T60、T120、T180、T240、T300、T360)시적평균동맥압(MAP),검측각시간점혈장동-자초양화물기화매(Cu2+-Zn2+-SOD)활성급병이철(MDA)함량；실험종점취심장、폐장、간장、신장、공장조직,측정조직내MDA、양화형화환원형곡광감태、곡광감태과양화물매、곡광감태환원매、과양화경매수평,홍간전후적조직칭중,계산조직함수솔적변화；실험종점취동맥혈,측정기산격매동공매(CK-MB)、동맥혈양분압(PaO2)、병안산전안매(ALT)、이알양화매(DAO)화혈기항(Cr)변화。결과：T120개시, RL조화RP조MAP교RN조명현승고(P<0.05),T300~T360,RP조 MAP교 RL조명현승고(P<0.05)。T120~T360,RP 조 Cu2+-Zn2+-SOD 활성비 RN 조현저승고,단화 RL 조무명현차별；T180~T360,RP 조혈장중MDA수평현저저우 RL조(P<0.05)。RP조복소후심、폐、간화공장조직내 MDA、양화형곡광감태함량교 RL조명현강저(P<0.05),환원형곡광감태교 RL조명현승고(P<0.05)；RP 조복소후심、간화공장조직내곡광감태과양화물매함량교 RL명현강저(P<0.05),곡광감태환원매교 RL조명현승고(P<0.05)；RP 조장기공능화조직함수솔균교 RL조개선경명현。결론：병동산납림격액복소재감경실혈성휴극후조직과양화인기적다장기공능손해화수종방면적작용명현우우유산납림격액,유조우실혈성휴극후내장과양화손상급병발증적방치。
Objective:To investigate the protective effects of pyruvate Ringer’s solution on lipid peroxidation in-jury-induced multiple organ dysfunction during resuscitation of hemorrhagic shock (HS)in rats. Methods:Hemor-rhagic shock was induced by withdrawing 45% of the calculated total blood volume within 20 minutes. Fifty-four SD rats were randomly divided into three groups (n=18). Group RN:HS with no fluid resuscitation. Group RL:HS resuscitated with commercial dl-lactate Ringer’s solution equal to 3 times the volume of shed blood. Group RP:HS resuscitated with pyruvate Ringer’s solution (pH 6.4)equal to 3 times the volume of shed blood. The mean arterial pressure (MAP)was monitored with PICCO cardiopulmonary capacity monitor,activities of Cu2+-Zn2+-superoxide dismutase (SOD)and the level of malondialdehyde (MDA)were determined 20 minutes before and 0,60,120,180,240,300,360 minutes after hemorrhage(T-20,T0,T60,T120,T180,T240,T300, T360).The content of MDA,oxidized and reduced glutathione,glutathione peroxidase,glutathione reductase and catalase in heart,lung,liver,kidney and j ej unum were determined at end of the experiment.Changes in creatine kinase (CK-MB),partial pressure of oxygen in artery (PaO2 ),alanine aminotransferase (ALT),diamine oxidase (DAO) and creatinine (Cr)were measured in arterial blood and plasma. The changes in water content in heart,lung,liv-er,kidney and jejunum were also measured.Results:At T120-360 after shock,the MAP in groups RL and RP was significantly higher than that of the group RN(P<0.05),and at T180-360,MAP in the group RP was signifi-cantly higher than that of the group RL(P<0.05). At T120-360,the blood Cu2+-Zn2+ SOD activities in group RP were significantly higher than that of group RN,but no significant difference was found when compared with those of the group RL. At T180-360,and the level of MDA was significantly lower in group RP than that in group RL(P<0.05). The content of MDA and oxidized glutathione in group RP was lower,but reduced glutathione was significantly higher than group RL in heart,lungs,liver and jejunum (P<0.05). The content of glutathione per-oxidase in group RP was lower but glutathione reductase was higher significantly than those in group RL in the heart,liver and jejunum (P<0.05). Protection of organ function and reduction of water content of tissues were pronounced in RP group as compared with RL group. Conclusions:Pyruvate Ringer’s solution may be significantly superior to lactate Ringer’s solution in alleviating multiple organ dysfunction and tissue edema induced by peroxida-tion after fluid resuscitation of HS.