CAJ | 학술논문

目的：评价乌司他丁对失血性休克∕复苏（ HS∕R）大鼠急性肺损伤的影响。方法选择SPF级成年SD大鼠15只，体重300～400 g，2～3月龄，采用随机数字表法，将其分为3组（ n＝5）：假手术组（ S组）、HS∕R组和乌司他丁组（ U组）。HS∕R组和U组通过颈动脉放血建立失血性休克大鼠模型，维持60 min后回输自体血和生理盐水行容量复苏。 U组于容量复苏前静脉注射乌司他丁5万U∕kg（1．0 ml），S组和HS∕R组以等容量生理盐水替代。于颈动脉穿刺置入套管针后（T0）、休克后5 min（ T1）、容量复苏前（ T2）、复苏至预定血压5 min（ T3）、容量复苏后30 min（ T4）、1．5 h（ T5）和2．5 h （ T6）时采集0．5 ml动脉血样，采用ELISA法测定血浆白细胞介素?6（ IL?6）和肿瘤坏死因子?α（ TNF?α）浓度。于T0、T2和T6时采集动脉血样0．5 ml行血气分析，记录pH值、PaCO2、HCO－3和BE值，计算氧合指数（ OI＝PaO2∕FiO2）。于T6时取肺组织行病理学评分，另取肺组织，分离细胞核，采用ELISA法测定核转录因子?κB（ NF?κB） p65水平。结果与S组比较， U组和HS∕R组pH值、HCO－3、BE值和OI降低，PaCO2和血浆IL?6和TNF?α浓度、肺组织NF?κB p65水平、病理学损伤评分升高（ P＜0．05）。与HS∕R组比较，U组血浆IL?6和TNF?α浓度、肺组织NF?κB p65水平、病理学损伤评分降低（ P＜0．05），血气分析指标比较差异无统计学意义（ P＞0．05）。结论乌司他丁虽然可减轻HS∕R大鼠肺损伤，但不足以改善肺氧合功能。
목적：평개오사타정대실혈성휴극∕복소（ HS∕R）대서급성폐손상적영향。방법선택SPF급성년SD대서15지，체중300～400 g，2～3월령，채용수궤수자표법，장기분위3조（ n＝5）：가수술조（ S조）、HS∕R조화오사타정조（ U조）。HS∕R조화U조통과경동맥방혈건립실혈성휴극대서모형，유지60 min후회수자체혈화생리염수행용량복소。 U조우용량복소전정맥주사오사타정5만U∕kg（1．0 ml），S조화HS∕R조이등용량생리염수체대。우경동맥천자치입투관침후（T0）、휴극후5 min（ T1）、용량복소전（ T2）、복소지예정혈압5 min（ T3）、용량복소후30 min（ T4）、1．5 h（ T5）화2．5 h （ T6）시채집0．5 ml동맥혈양，채용ELISA법측정혈장백세포개소?6（ IL?6）화종류배사인자?α（ TNF?α）농도。우T0、T2화T6시채집동맥혈양0．5 ml행혈기분석，기록pH치、PaCO2、HCO－3화BE치，계산양합지수（ OI＝PaO2∕FiO2）。우T6시취폐조직행병이학평분，령취폐조직，분리세포핵，채용ELISA법측정핵전록인자?κB（ NF?κB） p65수평。결과여S조비교， U조화HS∕R조pH치、HCO－3、BE치화OI강저，PaCO2화혈장IL?6화TNF?α농도、폐조직NF?κB p65수평、병이학손상평분승고（ P＜0．05）。여HS∕R조비교，U조혈장IL?6화TNF?α농도、폐조직NF?κB p65수평、병이학손상평분강저（ P＜0．05），혈기분석지표비교차이무통계학의의（ P＞0．05）。결론오사타정수연가감경HS∕R대서폐손상，단불족이개선폐양합공능。
Objective To evaluate the effects of ulinastatin on hemorrhagic shock and resuscitation ( HS∕R)?induced acute lung injury in rats. Methods Fifteen SPF adult Sprague?Dawley rats, aged 2-3 months, weighing 300-400 g, were divided into 3 groups ( n=5 each) using a random number table:sham operation group ( group S ) , HS∕R group and ulinastatin group ( group U ) . Carotid arteries were cannulated for blood pressure monitoring and blood?letting. HS∕R was induced by blood?letting and maintained for 1 h, followed by resuscitation with autologous blood transfusion and infusion of normal saline. After cannulation of carotid arteries ( T0 ) , at 5 min after hemorrhagic shock ( T1 ) , before resuscitation ( T2 ) , at 5 min after the expected blood pressure was achieved following resuscitation ( T3 ) , and at 30 min, 1?5 h and 2?5 h after resuscitation ( T4?6 ) , arterial blood samples were collected for determination of interleukin?6 ( IL?6 ) and tumor necrosis factor?α ( TNF?α) concentrations ( by enzyme?linked immunosorbent assay) . Arterial blood samples were collected at T0 , T2 and T6 for blood gas analysis. The pH value, partial pressure of arterial carbon dioxide ( PaCO2 ) , HCO-3 and base excess ( BE) value were recorded, and oxygenation index ( PaO2∕FiO2 ) was calculated. Lungs were removed at T6 , and pulmonary specimens were obtained for examination of pathological changes which were scored, and nucleus was extracted for determination of nuclear factor?kappa B ( NF?κB ) p65 expression by enzyme?linked immunosorbent assay. Results Compared with group S, the pH values, HCO-3 , BE values and OI were significantly decreased, and PaCO2 , plasma IL?6 and TNF?α concentrations, expression of NF?κB p65 in lung tissues, and pathological scores were increased in U and HS∕R groups. Compared with group HS∕R, the plasma concentrations of IL?6 and TNF?α, expression of NF?κB p65 in lung tissues, and pathological scores were significantly decreased, and no significant changes were found in parameters of blood gas analysis in group U. Conclusion Although ulinastatin can alleviate HS∕R?induced acute lung injury, it is insufficient to improve lung oxygenation in rats.