中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2013年
6期
347-350
,共4页
石海梅%周华成%贾雅蕊%王雅%刘金锋
石海梅%週華成%賈雅蕊%王雅%劉金鋒
석해매%주화성%가아예%왕아%류금봉
氢气%失血性休克%复苏%急性肺损伤
氫氣%失血性休剋%複囌%急性肺損傷
경기%실혈성휴극%복소%급성폐손상
Hydrogen%Hemorrhagic shock%Resuscitation%Acute lung injury
目的 探讨氢气对失血性休克复苏诱导大鼠急性肺损伤的影响.方法 按照随机数字表法将24只雄性SD大鼠均分为假手术组、模型组、氢气治疗组,采用缺血1h再灌注2h制备大鼠压力控制型失血性休克复苏模型,模型动物在制模过程中吸入50％氧气-50％氮气,氢气治疗组再灌注开始前10 min改为吸入2％氢气-48％氮气-50％氧气直至复苏结束.于放血前、休克1h和再灌注1h、2h取血,检测动脉血氧分压(PaO2)；实验结束时取血和肺组织标本,检测血浆中肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平,以及肺湿/干质量比值(W/D)、肺组织丙二醛(MDA)含量、超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)活性,并观察肺组织病理学改变.结果 再灌注结束后,与模型组相比,氢气治疗组可明显减轻肺水肿(肺W/D比值:4.72±0.12比4.94±0.14,P＜0.05),抑制氧化应激[MDA (nmol/mg):0.55±0.09比0.72±0.08,P＜0.05],增强抗氧化酶活性[SOD(U/mg):79.53±14.33比59.55±9.07,P＜ 0.05],减少促炎因子释放[TNF-α (ng/L):55.58±10.06比66.58±5.17,IL-6(ng/L):23.00±2.77比27.09±2.46,P＜0.05]及中性粒细胞浸润[MPO(U/g):1.05±0.18比1.40±0.14,P＜0.05],减轻肺组织病理学损伤,改善肺功能[PaO2(mm Hg,1 mm Hg=0.133 kPa):146.3±22.1比123.6±16.0,P＜ 0.05].结论 氢气治疗可减轻失血性休克复苏诱导的急性肺损伤.
目的 探討氫氣對失血性休剋複囌誘導大鼠急性肺損傷的影響.方法 按照隨機數字錶法將24隻雄性SD大鼠均分為假手術組、模型組、氫氣治療組,採用缺血1h再灌註2h製備大鼠壓力控製型失血性休剋複囌模型,模型動物在製模過程中吸入50％氧氣-50％氮氣,氫氣治療組再灌註開始前10 min改為吸入2％氫氣-48％氮氣-50％氧氣直至複囌結束.于放血前、休剋1h和再灌註1h、2h取血,檢測動脈血氧分壓(PaO2)；實驗結束時取血和肺組織標本,檢測血漿中腫瘤壞死因子-α(TNF-α)及白細胞介素-6(IL-6)水平,以及肺濕/榦質量比值(W/D)、肺組織丙二醛(MDA)含量、超氧化物歧化酶(SOD)、髓過氧化物酶(MPO)活性,併觀察肺組織病理學改變.結果 再灌註結束後,與模型組相比,氫氣治療組可明顯減輕肺水腫(肺W/D比值:4.72±0.12比4.94±0.14,P＜0.05),抑製氧化應激[MDA (nmol/mg):0.55±0.09比0.72±0.08,P＜0.05],增彊抗氧化酶活性[SOD(U/mg):79.53±14.33比59.55±9.07,P＜ 0.05],減少促炎因子釋放[TNF-α (ng/L):55.58±10.06比66.58±5.17,IL-6(ng/L):23.00±2.77比27.09±2.46,P＜0.05]及中性粒細胞浸潤[MPO(U/g):1.05±0.18比1.40±0.14,P＜0.05],減輕肺組織病理學損傷,改善肺功能[PaO2(mm Hg,1 mm Hg=0.133 kPa):146.3±22.1比123.6±16.0,P＜ 0.05].結論 氫氣治療可減輕失血性休剋複囌誘導的急性肺損傷.
목적 탐토경기대실혈성휴극복소유도대서급성폐손상적영향.방법 안조수궤수자표법장24지웅성SD대서균분위가수술조、모형조、경기치료조,채용결혈1h재관주2h제비대서압력공제형실혈성휴극복소모형,모형동물재제모과정중흡입50％양기-50％담기,경기치료조재관주개시전10 min개위흡입2％경기-48％담기-50％양기직지복소결속.우방혈전、휴극1h화재관주1h、2h취혈,검측동맥혈양분압(PaO2)；실험결속시취혈화폐조직표본,검측혈장중종류배사인자-α(TNF-α)급백세포개소-6(IL-6)수평,이급폐습/간질량비치(W/D)、폐조직병이철(MDA)함량、초양화물기화매(SOD)、수과양화물매(MPO)활성,병관찰폐조직병이학개변.결과 재관주결속후,여모형조상비,경기치료조가명현감경폐수종(폐W/D비치:4.72±0.12비4.94±0.14,P＜0.05),억제양화응격[MDA (nmol/mg):0.55±0.09비0.72±0.08,P＜0.05],증강항양화매활성[SOD(U/mg):79.53±14.33비59.55±9.07,P＜ 0.05],감소촉염인자석방[TNF-α (ng/L):55.58±10.06비66.58±5.17,IL-6(ng/L):23.00±2.77비27.09±2.46,P＜0.05]급중성립세포침윤[MPO(U/g):1.05±0.18비1.40±0.14,P＜0.05],감경폐조직병이학손상,개선폐공능[PaO2(mm Hg,1 mm Hg=0.133 kPa):146.3±22.1비123.6±16.0,P＜ 0.05].결론 경기치료가감경실혈성휴극복소유도적급성폐손상.
Objective To investigate the effect of hydrogen inhalation on acute lung injury after hemorrhagic shock in rats.Methods Twenty-four adult male Sprague-Dawley (SD) rats were equally randomized into three groups:sham operation group,model group and hydrogen-treatment group.Pressure-controlled hemorrhagic shock and resuscitation model was reproduced by blood-letting for 1 hour followed by fluid replacement for 2 hours.The rats in model group received a mixture of 50％ oxygen-50％ nitrogen during the process.The rats in hydrogen-treatment group received inhalation of a mixture of 2％ hydrogen-48％ nitrogen-50％ oxygen 10 minutes before fluid replacement till the end of resuscitation.The arterial blood samples were collected for the measurement of arterial partial pressure of oxygen (PaO2) before exsanguination,1 hour after shock,1 hour and 2 hours after fluid replacement.Blood and lung tissues were collected at the end of experiment,and tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels in plasma,lung wet/dry weight ratio (W/D),malondialdehyde (MDA) content,superoxide dismutase (SOD) and myeloperoxidase (MPO) activity in the lung tissue were determined.The lung tissue was subjected to pathological examination.Results At the end of fluid replacement,compared with model group,hydrogen could significantly reduce pulmonary edema (lung W/D ratio:4.72 ± 0.12 vs.4.94 ± 0.14,P＜0.05),inhibit oxidative stress [MDA (nmol/mg):0.55 ± 0.09 vs.0.72± 0.08,P＜O.05],enhance antioxidant activity [SOD activity (U/mg):79.53 ± 14.33 vs.59.55 ± 9.07,P＜0.05],reduce the release of pro-inflammatory cytokines [TNF-α (ng/L):55.58 ± 10.06 vs.66.58 ± 5.17; IL-6 (ng/L):23.00 ± 2.77 vs.27.09 ± 2.46,P＜ 0.05] and inhibit neutrophil infiltration [MPO (U/g):1.05 ± 0.18 vs.1.40 ± 0.14,P＜0.05].It alleviated the damage to lung tissue,and then improved the lung function [PaO2 (mm Hg,1 mm Hg=0.133 kPa):146.3 ± 22.1 vs.123.6 ± 16.0,P＜0.05].Conclusion Hydrogen treatment can alleviate acute lung injury as a result of hemorrhagic shock and resuscitation.
