【摘要】：目的探討應用羥乙基淀粉(HES)溶液中添加多聚人胎盤血紅蛋白(Poly Hb)對重度失血性休克大鼠模型腸缺血再灌注的影響。方法將32只SD大鼠失血至全身血容量(大鼠體重的6.5%)的60%,分別將大鼠股動靜脈插管后,從股動脈端開始放血直至放血量達到大鼠全身血容量的60%,然后隨機均分為4組(8只/組),包括3個人工膠體液組,即HES組:6%HES130/0.4氯化鈉注射液;紅細胞+HES(RBC+HES)組:將大鼠自身血液反復離心洗滌3次,留取紅細胞,加入到HES溶液中,使Hb濃度達到20 g/L;Poly Hb+HES組:將Poly PHb加入到HES溶液中,使Hb濃度為20 g/L;1個假手術(shù)組:只做常規(guī)手術(shù),不放血不復蘇。將大鼠行等容量液體復蘇,分別在各組大鼠休克前、后,輸液末、輸液后1 h、2 h觀測大鼠平均動脈壓(MAP)、乳酸(Lac)、氧分壓(Pa O2)、二氧化碳分壓(Pa CO2),并在復蘇2 h取各組大鼠腸組織制備成10%組織勻漿,測定丙二醛(MDA)、髓過氧化物酶(MPO)、腫瘤壞死因子(TNF-α)的含量。結(jié)果 HES、RBC+HES和Poly Hb+HES 3組大鼠輸液后MAP(mm Hg)分別為88.00±9.90 vs 100.57±7.69vs 112.16±17.05(P"0.05);輸液后2 h,乳酸(mmol/L)分別為3.71±0.91 vs 2.30±0.97 vs 2.50±0.65(P"0.05),Pa O2(mm Hg)分別為126.5±10.40 vs 111.16±9.64 vs 111.00±13.98(P"0.05),Pa CO2(mm Hg)分別為30.00±3.16 vs 42.66±5.31 vs 34.66±1.50(P"0.05);輸液后2 h,RBC+HES、HES組MDA、MPO活性,分別為:0.47±0.34 vs 0.99±0.81,0.23±0.29 vs 0.57±0.32(P"0.05);Poly Hb+HES與HES組MPO活性、TNF-α分別為0.32±0.19 vs 0.57±0.32,89.42±21.03 vs 208.45±62.80(P"0.05)。結(jié)論 HES溶液添加多Poly Hb可以改善失血性休克大鼠組織氧供和酸中毒現(xiàn)象,減輕腸組織缺血再灌注損傷。
[Abstract]:Objective to investigate the effect of adding polyhedrine placental hemoglobin (Poly Hb) into hydroxyethyl starch (HES) solution on intestinal ischemia-reperfusion in rats with severe hemorrhagic shock. Methods 32 SD rats lost blood to 60% of the whole body blood volume (6.5% of the body weight of the rats). The femoral arteries and veins of the rats were intubated respectively. From the end of femoral artery to 60% of the whole body blood volume of rats, the rats were randomly divided into 4 groups (8 rats / group), including three artificial colloid solution groups, namely, HES group (HES group): 1 / 6 HES130 / 0.4 sodium chloride injection; Red blood cell HES (RBC HES) group: rats' own blood was washed by repeated centrifugation for 3 times, red blood cells were retained and added to HES solution, the concentration of Hb reached 20 g / L / L Poly Hb HES group: Poly PHb was added to HES solution, Hb concentration was 20 g / L; 1 sham operation group: only routine operation, no bleeding, no resuscitation. The rats were resuscitated with isobaric fluid before and after shock. The mean arterial pressure (MAP), (Lac), oxygen pressure (Pa O 2) and partial pressure of carbon dioxide (Pa CO2) were measured 1 h after infusion, and 10% tissue homogenate was prepared from intestinal tissue of each group at 2 h after resuscitation. The content of malondialdehyde (MDA) (MDA), myeloperoxidase (MPO),) tumor necrosis factor (TNF- 偽) was determined. 緇撴灉 HES,RBC HES鍜孭oly Hb HES 3緇勫ぇ榧犺緭娑插悗MAP(mm Hg)鍒嗗埆涓，

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