不同复苏液对失血性休克大鼠血中粘附分子表达的影响

中国临床药理学与治疗学 ›› 2007, Vol. 12 ›› Issue (4): 422-426.

不同复苏液对失血性休克大鼠血中粘附分子表达的影响

王晓蓉¹, 潘景业¹, 朱椰凡², 王明山³, 沈志坚¹, 林锡芳¹, 林碎钗¹, 陈洁¹

¹温州医学院第一附属医院ICU,²肝胆外科,³检验科, 温州325000, 浙江

收稿日期:2006-12-27 修回日期:2006-12-27 发布日期:2020-10-30
基金资助:
浙江省温州市科研基金资助项目(Y2006A005)

Effects of various of resuscitation fluids on expression of soluble cell adhesion molecules in rats with hemorrhagic shock

WANG Xiao-rong¹, PAN Jing-ye¹, ZHU Ye-fan², WANG Ming-san³, SHEN Zhi-jian¹, LIN Xi-fang¹, LIN Sui-chai¹, CHEN Jie¹

¹ICU, ²Department of General Surgery, ³Department of Medical Examination, the First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, Zhejiang, China

Received:2006-12-27 Revised:2006-12-27 Published:2020-10-30

摘要/Abstract

摘要： 目的观察不同复苏液对失血性休克大鼠血浆血小板α颗粒膜糖蛋白-140(GMP-140) 、血清可溶性血管细胞粘附分子-1(sVCAM-1) 及可溶性细胞间粘附分子-1(sICAM-1) 表达的影响, 并探讨其可能机制。方法 50 只SD 大鼠随机分为5 组(对照组、假手术组、休克组、林格组和万汶组), 每组10 只。建立失血性休克大鼠模型后, 复苏各组在失血性休克1 h 后给予不同复苏液(林格氏液、6 %中分子羟乙基淀粉130 0.4), 复苏2 h 后采血, 检测血浆GMP-140 、血清sVCAM-1 及sICAM-1 的变化。结果与对照组比较, 休克组和林格组GMP-140 、sVCAM-1 、sICAM-1均明显升高(P<0.01), 而万汶组改变不明显;与假手术组相比, 休克组的GMP-140 、sVCAM-1 、sICAM-1明显升高(P<0.01);林格组的GMP-140 亦明显升高, 余两项指标未见明显变化;万汶组的GMP-140 、sVCAM-1 、sICAM-1 改变不明显;相对于休克组, 林格组的sVCAM-1 下降明显(P<0.01), sICAM-1 虽有下降, 但差异无统计学意义;而万汶组的GMP-140 、sICAM-1 、sVCAM-1 均明显低于休克组和林格组(P<0.01) 。结论大鼠失血性休克可使纤溶功能亢进,血小板和凝血系统被活化;采用万汶+林格液复苏在调节凝血功能方面优于单用林格液复苏;休克早期经充分的液体复苏后, 不管是万汶还是林格液都可能会改善微循环。其可能的原因是血液稀释具有抗缺血再灌注损伤的作用, 应用万汶可能减少内皮细胞损伤并改善微循环。

关键词: 失血性休克, 凝血因子, 输液治疗, 万汶, 可溶性细胞粘附分子

Abstract: AIM: To investigate the changes of blood soluble adhesion molecules during hemorrhagic shock in rats and the effects of various of resuscitation fluids on expression of blood cell adhesion molecules in rats with hemorrhagic shock. METHODS: 50 SD rats were divided into 5 (control, sham, shock, lactated Ringer's and 6 % hydroxyethylstarch) groups randomly.Lactated Ringer's group and hydroxye-thylstarch group were subjected to hemorrhagic shock for 1 h, followed by resuscitation with lactated Ringer's solution and 6 % hydroxyethylstarch for 2 h by three times of the lost blood.After resuscitation, the GMP-140, sVCAM-1 and sICAM-1 were measured.At the same time, the control, the shock and the sham groups were drawn the blood to test. RESULTS: Blood plasma GMP-140, sVCAM-1 and sICAM-1 in the shock group were significantly higher than those of the control and sham group (P<0.01).Blood GMP-140, sVCAM-1 and sICAM-1 in Lactated Ringer's group were higher than those of the control group (P<0.01). Plasma GMP-140 in Lactated Ringer's group were higher than that of the sham group (P<0.01).Serum sVCAM-1 in Lactated Ringer's group was higher than that of the shock group (P<0.01).Compared with the shock group and Lactated Ringer's group, the GMP-140, sVCAM-1 and sICAM-1 were reduced in the hydroxyeth-ylstarch group (P<0.01). CONCLUSION: It is concluded that hemorrhagic shock triggers the coagulation cascade reaction, and the coagulation of the actors is greatly consumed.Unbalance of coagulation system plays an important role in the progress of shock.Resuscitation with 6 % hydroxyethylstarch may reduce the inflammatory response in rats undergoing hemorrhagic shock compared to a crystalloid-based volume therapy.Hypothesize that this is most likely due to an improved microcirculation with reduced endothelial activation and less endothelial damage.

Key words: hemorrhagic shock, blood coagulation factor, transfusion therapy, 6 % hydroxyethylstarch, soluble cell adhesion molecules

中图分类号:

王晓蓉, 潘景业, 朱椰凡, 王明山, 沈志坚, 林锡芳, 林碎钗, 陈洁. 不同复苏液对失血性休克大鼠血中粘附分子表达的影响[J]. 中国临床药理学与治疗学, 2007, 12(4): 422-426.

WANG Xiao-rong, PAN Jing-ye, ZHU Ye-fan, WANG Ming-san, SHEN Zhi-jian, LIN Xi-fang, LIN Sui-chai, CHEN Jie. Effects of various of resuscitation fluids on expression of soluble cell adhesion molecules in rats with hemorrhagic shock[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2007, 12(4): 422-426.

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