CAJ | 학술논문

目的：观察分析虎杖苷对于重症失血性休克患者心功能及外周血血小板线粒体影响。方法以青海大学附属医院2010年1月～2015年5月收治的60例重症失血性休克患者为研究对象，对照组给予静脉生理盐水＋输血治疗，观察组给予虎杖苷（10 mg／kg）＋输血治疗。治疗结束后比较2组治疗前后的心功能指标（心脏射血分数与心输出量）、心肌细胞蛋白激酶C（ protein kinase C，PKC）、血小板线粒体ATP水平、血小板线粒体膜电位、血小板内脂质过氧化物（ lipid peroxide，LPO）水平进行分析比较。结果治疗后2组射血分数与心输出量均较治疗前显著增加（P＜0.05），且观察组上述2项指标均优于对照组（P＜0.05）。治疗后2组胞膜、胞质PKC较治疗前显著增加（P＜0.05），且观察组胞膜、胞质PKC显著高于对照组（P＜0.05）。治疗后2组血小板内ATP水平均较治疗前均显著增高（P＜0.05），且观察组血小板内ATP相对含量显著高于对照组（P＜0.05）。治疗后观察组低线粒体膜电位细胞含量较治疗前显著降低（P＜0.05），对照组则较治疗前无显著变化，观察组低线粒体膜电位细胞含量显著低于对照组（P＜0.05）。治疗后观察组LPO含量显著降低（P＜0.05），对照组较治疗前无显著变化，观察组LPO含量低于对照组（P＜0.05）。结论线粒体的损伤在重症休克的发生发展中发挥着重要作用，外周血血小板线粒体功能可作为判断休克病情的简易性指标，同时应用线粒体保护剂后线粒体功能得到保护，患者心功能获得显著改善，因此在重症休克的诊治中具有重要意义。
목적：관찰분석호장감대우중증실혈성휴극환자심공능급외주혈혈소판선립체영향。방법이청해대학부속의원2010년1월～2015년5월수치적60례중증실혈성휴극환자위연구대상，대조조급여정맥생리염수＋수혈치료，관찰조급여호장감（10 mg／kg）＋수혈치료。치료결속후비교2조치료전후적심공능지표（심장사혈분수여심수출량）、심기세포단백격매C（ protein kinase C，PKC）、혈소판선립체ATP수평、혈소판선립체막전위、혈소판내지질과양화물（ lipid peroxide，LPO）수평진행분석비교。결과치료후2조사혈분수여심수출량균교치료전현저증가（P＜0.05），차관찰조상술2항지표균우우대조조（P＜0.05）。치료후2조포막、포질PKC교치료전현저증가（P＜0.05），차관찰조포막、포질PKC현저고우대조조（P＜0.05）。치료후2조혈소판내ATP수평균교치료전균현저증고（P＜0.05），차관찰조혈소판내ATP상대함량현저고우대조조（P＜0.05）。치료후관찰조저선립체막전위세포함량교치료전현저강저（P＜0.05），대조조칙교치료전무현저변화，관찰조저선립체막전위세포함량현저저우대조조（P＜0.05）。치료후관찰조LPO함량현저강저（P＜0.05），대조조교치료전무현저변화，관찰조LPO함량저우대조조（P＜0.05）。결론선립체적손상재중증휴극적발생발전중발휘착중요작용，외주혈혈소판선립체공능가작위판단휴극병정적간역성지표，동시응용선립체보호제후선립체공능득도보호，환자심공능획득현저개선，인차재중증휴극적진치중구유중요의의。
Objective To analyze the effect of polydatin on cardiac function and mitochondrion of platelet in peripheral blood of patients with severe hemorrhagic shockpolydatin.Methods 60 patients with severe hemorrhagic shock from January 2010 to May 2015 in the hospital were selected.The control group adopted the intravenous therapy of normal saline and transfusion therapy and observation group adopted polydatin (10mg/kg) and transfusion therapy.After treatment, the cardiac function index including heart ejection fraction and and cardiac output, protein kinase C (PKC), ATP levels in mitochondria of platelet, platelet mitochondrial membrane potential and lipid peroxide ( LPO ) in platelet were compared between two groups.Results After treatment, the ejection fraction and cardiac output of two groups increased compared with pre-treatment ( P <0.05 ) , and the above indicators in observation group increased compared with control group (P<0.05).After treatment, PKC content in cell membrane and cytoplasm increased compared with pre-treatment (P<0.05), and the above indicators in observation group increased compared with control group (P<0.05). After treatment, the ATP level in two groups increased compared with pre-treatment (P<0.05), and the above indicator in observation group increased compared with control group ( P <0.05 ).After treatment, platelet cell rate of low mitochondrial membrane potential in observation group decreased compared with pre-treatment (P<0.05), but there was no significant difference in control group, the above indicator in observation group was lower than that in control group (P<0.05).After treatment, LPO content in observation group decreased compared with pre-treatment (P<0.05), but there was no significant difference in control group, the above indicator in observation group was lower than that in control group (P<0.05).Conclusion The injury of mitochondrion plays an important role in occurrence and development of severe hemorrhagic shockpolydatin.The function of peripheral blood platelet mitochondrion could be seen as a simple index of judging the state of shock.After the application of protective agent of mitochondrion, the function of mitochondrion is protected.The cardiac function is also improved.It has an important significance for the diagnosis of severe shock.