CAJ | 학술논문

目的：探讨小剂量减阻剂聚环氧乙烷（ PEO）在脓毒症大鼠液体复苏中的作用。方法48只雄性Wistar大鼠（180～200 g）随机分为四组，每组12只。分别为生理盐水对照组（ NS组）、空白对照组（ NT组）、聚环氧乙烷低剂量组（ PEO1组）和聚环氧乙烷高剂量组（ PEO2组）。采用盲肠结扎穿刺法制造脓毒症感染模型。术后16 h开始复苏，复苏时间为4 h （空白对照组不复苏）。同时显微镜下观察记录脊斜肌微循环状态，并在复苏前、复苏后和存活72 h后采血检测乳酸浓度和炎症因子，全程记录血压、心率。复苏结束后观察各组生存时间。结果四组心率比较差异无统计学意义；空白对照组血压稍低于其余三组，除空白对照组外三组血压比较差异无统计学意义。两组聚环氧乙烷给药10 min后均能使脊斜肌小动脉红细胞流速明显增加，但高剂量组（ PEO2组）流速很快下降，低剂量组（ PEO1组）可维持至复苏结束。生理盐水对照组和空白对照组并不能使流速明显增快。复苏结束时低剂量组（ PEO1组）流速明显高于其余三组，动物生存率也高于其余三组。结论小剂量PEO并不明显改变实验动物心率、血压，但可以明显增加脓毒症大鼠脊斜肌小动脉血流速度，提高实验动物生存率。
목적：탐토소제량감조제취배양을완（ PEO）재농독증대서액체복소중적작용。방법48지웅성Wistar대서（180～200 g）수궤분위사조，매조12지。분별위생리염수대조조（ NS조）、공백대조조（ NT조）、취배양을완저제량조（ PEO1조）화취배양을완고제량조（ PEO2조）。채용맹장결찰천자법제조농독증감염모형。술후16 h개시복소，복소시간위4 h （공백대조조불복소）。동시현미경하관찰기록척사기미순배상태，병재복소전、복소후화존활72 h후채혈검측유산농도화염증인자，전정기록혈압、심솔。복소결속후관찰각조생존시간。결과사조심솔비교차이무통계학의의；공백대조조혈압초저우기여삼조，제공백대조조외삼조혈압비교차이무통계학의의。량조취배양을완급약10 min후균능사척사기소동맥홍세포류속명현증가，단고제량조（ PEO2조）류속흔쾌하강，저제량조（ PEO1조）가유지지복소결속。생리염수대조조화공백대조조병불능사류속명현증쾌。복소결속시저제량조（ PEO1조）류속명현고우기여삼조，동물생존솔야고우기여삼조。결론소제량PEO병불명현개변실험동물심솔、혈압，단가이명현증가농독증대서척사기소동맥혈류속도，제고실험동물생존솔。
Objective To investigate the effects of polyethylene oxide ( a low-dose drag-reducing polymer ) on fluid resuscitation in septic rats .Methods A total of 48 male Wistar rats weighing 180 g to 200 g were enrolled and randomized into four groups , with 12 rats per group .The low-dose and high -dose polyethylene oxide group ( PEO1 and PEO2 group ) were treated with polyethylene oxide of 10 ppm ( parts per million ) or 50 ppm, respectively .The control group ( NS group) was treated with physiologic saline , and the blank control group ( NT group ) without fluid resuscitation.A sepsis model was established by cecal ligation and puncture (CLP) in all animals.The resuscitation was started 16 h after the operation of CLP , and the resuscitation was lasted for 4 hours. Simultaneously , the microcirculation in spinotrapezius muscle was observed under a microscope and the results were recorded .The blood pressure and heart rate were recorded .The lactic acid concentration in the blood samples was detected before resuscitation , at the end of resuscitation and 72 hours after the end of resuscitation .The survival time of each group was observed .Results The survival rate in PEO1 group was higher than the other three groups 72 h after resuscitation .The two groups treated with polyethylene oxide had a significant increase in red blood cell ( RBC) velocity of the arterioles in the spinotrapezius muscle 10 min after the beginning of resuscitation ( P <0.05 ); The RBC velocity in PEO1 group remained constant until the end of resuscitation .But the RBC velocity in PEO2 group was gradually returned to its original level in 60 min.Neither the control group nor the blank control group had a significant increase in RBC flow velocities (P>0.05).At the end of resuscitation, the RBC velocity in PEO1 group was significantly higher than that in other three groups .There was no significant change in heart rate during resuscitation in all groups (P>0.05).The blood pressure in PEO1, PEO2 and NS groups showed no significant change during resuscitation (P>0.05).But it was decreased in NT group during resuscitation (P<0.05).In addition, the lactic acid concentrations in the PEO1, PEO2 and NS groups were significantly decreased during resuscitation (P<0.05), but there was no significant change in the NT group during resuscitation ( P >0.05 ).Conclusion PEO does not significantly change the heart rate and blood pressure of the septic animals , low-dose PEO (10 ppm) can significantly increase the velocity of RBC of arteriole in spinotrapezius muscle in septic rats and improve survival rate.The high-dose PEO (50 ppm) has no improvement of the final velocity of RBC and survival rate .