CAJ | 학술논문

目的探讨晶体、胶体及晶体胶体复合液限制性复苏对失血性休克大鼠血浆白细胞介素-4(IL-4)和IL-10的影响。方法将24只健康SD大鼠按数字表法随机分成对照组,乳酸钠林格液复苏组(晶体组),羟乙基淀粉复苏组(胶体组),乳酸钠林格液与羟乙基淀粉共同复苏组(晶胶组)进行实验研究。3个实验复苏组先通过从大鼠股动脉放血制作失血性休克模型,分别在休克开始前(T0)、休克大鼠平均动脉压(MAP)在40 mmHg维持30 min时(T1)、MAP在60 mmHg维持30 min时(T2)、MAP在80 mmHg维持60 min时(T3)以及复苏成功24 h后(T4)取大鼠外周血,对照组只在实验前和相当于实验组的T4时点取血,采用ELISA法检测血浆IL-4和IL-10水平。结果各组大鼠周龄、体质量及实验前MAP比较,差异均无统计学意义(P值均>0.05)。各组大鼠在T0时点及各实验组在T1、T2时点血浆IL-4和IL-10水平比较,差异均无统计学意义(P值均>0.05)。在复苏过程中,晶体组和胶体组血浆IL-4和IL-10水平总体呈下降趋势,T3和T4时点晶胶组血浆IL-4和IL-10的水平均较晶体组和胶体组升高,T4时点对照组血浆IL-4和IL-10的水平均较晶体组和胶体组升高,差异均有统计学意义(P值均<0.01)。结论3种液体对失血性休克大鼠进行限制性复苏的过程中,晶胶液相对于晶体液、胶体液能更好地促进休克机体抑炎介质的释放,是一种相对较理想的复苏液体。
목적탐토정체、효체급정체효체복합액한제성복소대실혈성휴극대서혈장백세포개소-4(IL-4)화IL-10적영향。방법장24지건강SD대서안수자표법수궤분성대조조,유산납림격액복소조(정체조),간을기정분복소조(효체조),유산납림격액여간을기정분공동복소조(정효조)진행실험연구。3개실험복소조선통과종대서고동맥방혈제작실혈성휴극모형,분별재휴극개시전(T0)、휴극대서평균동맥압(MAP)재40 mmHg유지30 min시(T1)、MAP재60 mmHg유지30 min시(T2)、MAP재80 mmHg유지60 min시(T3)이급복소성공24 h후(T4)취대서외주혈,대조조지재실험전화상당우실험조적T4시점취혈,채용ELISA법검측혈장IL-4화IL-10수평。결과각조대서주령、체질량급실험전MAP비교,차이균무통계학의의(P치균>0.05)。각조대서재T0시점급각실험조재T1、T2시점혈장IL-4화IL-10수평비교,차이균무통계학의의(P치균>0.05)。재복소과정중,정체조화효체조혈장IL-4화IL-10수평총체정하강추세,T3화T4시점정효조혈장IL-4화IL-10적수평균교정체조화효체조승고,T4시점대조조혈장IL-4화IL-10적수평균교정체조화효체조승고,차이균유통계학의의(P치균<0.01)。결론3충액체대실혈성휴극대서진행한제성복소적과정중,정효액상대우정체액、효체액능경호지촉진휴극궤체억염개질적석방,시일충상대교이상적복소액체。
Objective To investigate the effects of crystal solution, colloidal solution and crystal glue solution in restrictive resuscitation on interleukin ( IL )-4 and IL-10 in rats of hemorrhagic shock. Methods Twenty-four healthy SD rats were randomly divided into four groups: one normal control group and three experimental groups, the latter contained sodium Lactated Ringer’s group ( crystal group ) , Hydroxyethyl Starch group ( colloidal group ) , sodium Lactated Ringer’s and Hydroxyethyl Starch group ( crystal glue group) . The hemorrhagic shock models were established in the three experimental groups by bleeding through the femoral artery. Peripheral blood of rats in each experimental group was collected for five times:before shock (T0), after 30 minutes of keeping mean arterial pressure(MAP) in 40 mmHg (T1), after 30 minutes of keeping MAP in 60 mmHg(T2), after 30 minutes of keeping MAP in 80 mmHg (T3), and at 24h after successful resuscitation(T4). The blood of rats in normal control group was only collected at the same time when T0 and T4 came. ELISA method was used to measure IL-4 and IL-10 content in plasma. Results There were no significant differences in the age, weight and MAP before experiment among all groups (all P values>0. 05). Before shock (at T0) , the contents of IL-4 and IL-10 in plasma of each group rats had no statistical significance(all P values>0. 05). When the shock began (at T1 and T2), the contents of IL-4 and IL-10 in plasma of each experimental group rats had no statistical significance ( all P values>0. 05). In the process of restrictive resuscitation, the contents of IL-4 and IL-10 in crystal group and colloidal group were decreasing. The contents of IL-4 and IL-10 in crystal glue group were higher than that of the crystal group or colloidal group at T3 and T4. The contents of IL-4 and IL-10 in normal control group were higher than that of the crystal group or colloidal group at T4, the difference had statistical significance (all P values<0. 01). Conclusions In the process of restrictive resuscitation, crystal glue solution can better accelerate the release of anti-inflammatory mediators. Crystal glue solution may be a relatively better restrictive resuscitation liquid.