中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
Chinese Journal of Anesthesiology
2015年
9期
1121-1123
,共3页
血液稀释%呼吸窘迫综合征,成人
血液稀釋%呼吸窘迫綜閤徵,成人
혈액희석%호흡군박종합정,성인
Hemodilution%Respiratory distress syndrome,adult
目的 评价不同时程深度急性高容血液稀释(AHH)对兔急性肺损伤的影响.方法 健康成年家兔36只,体重2.7～3.1 kg,雌雄不拘,采用随机数字表法,将其分为2组(n=18):对照组(C组)和AHH组.AHH组静脉输注6％羟乙基淀粉130/0.4行AHH,目标Hct为20％.于AHH前即刻(T0)、AHH后1 h(T1)、2 h(T2)和4h(T3)时,采集右股动脉血样行血气分析,计算氧合指数,记录急性肺损伤(氧合指数≤300 mmHg)的发生情况.于T1-3时采集血样后,每组处死6只兔,取肺组织,测定湿重/干重比值,并采用免疫组化法检测水通道蛋白-1表达.结果 AHH组AHH后1～2h有1只家兔发生急性肺损伤,AHH后2～4h有4只家兔发生急性肺损伤.与C组比较,AHH组T1-3时湿重/干重比值升高,T23时肺组织水通道蛋白-1表达降低(P＜0.05或0.01).结论 6％羟乙基淀粉130/0.4进行深度AHH,目标Hct 20％,时程＞1h时,兔发生急性肺损伤.
目的 評價不同時程深度急性高容血液稀釋(AHH)對兔急性肺損傷的影響.方法 健康成年傢兔36隻,體重2.7～3.1 kg,雌雄不拘,採用隨機數字錶法,將其分為2組(n=18):對照組(C組)和AHH組.AHH組靜脈輸註6％羥乙基澱粉130/0.4行AHH,目標Hct為20％.于AHH前即刻(T0)、AHH後1 h(T1)、2 h(T2)和4h(T3)時,採集右股動脈血樣行血氣分析,計算氧閤指數,記錄急性肺損傷(氧閤指數≤300 mmHg)的髮生情況.于T1-3時採集血樣後,每組處死6隻兔,取肺組織,測定濕重/榦重比值,併採用免疫組化法檢測水通道蛋白-1錶達.結果 AHH組AHH後1～2h有1隻傢兔髮生急性肺損傷,AHH後2～4h有4隻傢兔髮生急性肺損傷.與C組比較,AHH組T1-3時濕重/榦重比值升高,T23時肺組織水通道蛋白-1錶達降低(P＜0.05或0.01).結論 6％羥乙基澱粉130/0.4進行深度AHH,目標Hct 20％,時程＞1h時,兔髮生急性肺損傷.
목적 평개불동시정심도급성고용혈액희석(AHH)대토급성폐손상적영향.방법 건강성년가토36지,체중2.7～3.1 kg,자웅불구,채용수궤수자표법,장기분위2조(n=18):대조조(C조)화AHH조.AHH조정맥수주6％간을기정분130/0.4행AHH,목표Hct위20％.우AHH전즉각(T0)、AHH후1 h(T1)、2 h(T2)화4h(T3)시,채집우고동맥혈양행혈기분석,계산양합지수,기록급성폐손상(양합지수≤300 mmHg)적발생정황.우T1-3시채집혈양후,매조처사6지토,취폐조직,측정습중/간중비치,병채용면역조화법검측수통도단백-1표체.결과 AHH조AHH후1～2h유1지가토발생급성폐손상,AHH후2～4h유4지가토발생급성폐손상.여C조비교,AHH조T1-3시습중/간중비치승고,T23시폐조직수통도단백-1표체강저(P＜0.05혹0.01).결론 6％간을기정분130/0.4진행심도AHH,목표Hct 20％,시정＞1h시,토발생급성폐손상.
Objective To evaluate the effects of different durations of severe acute hypervolemic hemodilution (AHH) on acute lung injury in rabbits.Methods Thirty-six healthy adult rabbits of both sexes, weighing 2.7-3.1 kg, were randomly divided into 2 groups (n=18 each) using a random number table: control group (C group) and AHH group.AHH was performed with 6％ hydroxyethyl starch 130/0.4 until the target hematocrit of 20％ was achieved in group AHH.Immediately before AHH (T0) , and at 1,2 and 4 h after AHH (T1-3) , blood samples were taken from the right femoral artery for blood gas analysis.The oxygenation index was calculated.The occurrence of acute lung injury (oxygenation index ≤ 300 mm-Hg) was recorded.After blood samples were collected at T1-3 , 6 rabbits in each group were sacrificed, and lungs were removed for determination of wet/dry lung weight ratio (W/D ratio) and aquaporin-1 (AQP-1) expression (by immuno-histochemistry).Results In group AHH, 1 rabbit developed acute lung injury at 1-2 h after AHH, and 4 rabbits developed acute lung injury at 2-4 h after AHH.Compared with group C,W/D ratio was significantly increased at T1-3, and the expression of AQP-1 was down-regulated at T2,3 in group AHH (P＜0.05 or 0.01).Conclusion Severe AHH performed with 6％ hydroxyethyl starch 130/ 0.4 with the target hematocrit reduced to 20％ and the duration ＞ 1 h induces acute lung injury in rabbits.
