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三种液体复苏对重度失血性休克大鼠肝脏氧自由基的影响
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三种液体复苏对重度失血性休克大鼠肝脏氧自由基的影响
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Journal Article
三种液体复苏对重度失血性休克大鼠肝脏氧自由基的影响
2012
Overview
目的探讨不同液体复苏对重度失血性休克大鼠肝脏氧自由基的影响及其可能的机制。方法60只SD大鼠随机分为5组（n=12）：对照组（c组）、乳酸林格液组（LR组）、6％羟乙基淀粉组（HES组）、7．2％高渗盐／6％羟乙基淀粉组（HSH组）、单纯休克组（sA组）。采用改良Wiggers法复制重度失血性休克动物模型，监测各组大鼠平均动脉压（MAP）变化。分别于休克前（Tb）、休克1h即刻（Ts）及复苏后4h（Td）取静脉血测丙氨酸转氨酶（ALT）及天冬氨酸转氨酶（AST）含量。sA组大鼠在Ts时间点处死取肝组织保存。LR、HES及HSH组分别以3倍失血量LR液、1倍失血量的HES液和6ml／kg的HSH液复苏。LR、HES、HSH及C组大鼠在Td时间点处死，取肝组织，采用免疫组化sP法检测TNF．d、NF．KB蛋白表达水平，比色法检测过氧化物歧化酶（SOD）活性和丙二醛（MDA）含量，ELISA双抗夹心法检测诱导型一氧化氮合酶（iNOS）含量，电镜及光镜下观察肝组织病理学变化。结果在复苏4h内HES维持MAP的稳定效果优于LR及HSH。与C组比较，其余各组血qhAST及ALT明显升高（P〈0．05），肝组织iNOS、NF-KB表达升高，MDA含量增加，SOD活性降低（P〈0．05），肝组织病理学损伤明显；与sA组比较，LR、HES及HSH组上述指标表达升高，肝组织病理损伤明显。LR、HES及HSH组间比较，LR组上述指标升高最显著，肝组织病理损伤最重，而HSH组各指标表达减少，肝组织病理损伤较轻。结论HsH能减少肝组织iNOS、NF—KB的产生，降低氧自由基引起的脂质过氧化反应，减轻失血性休克后肝组织损伤。
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