本文選題：高容量血液濾過 + 感染性休克��； 參考：《揚州大學》2013年碩士論文

【摘要】：目的： 探討高容量血液濾過聯(lián)合早期液體復蘇對感染性休克造成的器官功能障礙的保護作用的分子及病理生理機制。 研究對象： 健康約克夏家豬(體重23-25kg) 方法： 18只豬隨機分為對照組、CRRT組和HVHF組。使用50ug/(kg.h)稀釋大腸埃希氏菌脂多糖(LPS)持續(xù)靜脈泵人,誘導感染性休克模型,然后經(jīng)過液體復蘇及血管活性藥物維持保證組織灌注血壓水平,分別給與常規(guī)治療、常規(guī)流量血液濾過(CRRT25ml/(kg.h))以及高容量血液濾過(HVHF85ml/(kg.h))治療。監(jiān)測每組的血流動力學指標,PICCO監(jiān)測指標,血管活性藥物用量及維持時間,測定血漿中IL-6, IL-10的濃度,檢測各主要臟器的NF-kappa B中mRNA的相對表達量以及進行病理組織切片檢查。 結果： 早期高容量血液濾過能夠明顯降低組織器官NF-kappa B的表達水平,有效降低血漿炎性因子水平,減少血管活性藥物的用量及維持時間,減輕組織器官的損害。 結論： NF-kappa B的過度活化以及炎癥反應在多臟器功能損害中起著重要的作用,HVHF能夠通過抑制NF-kappa B的過度活化,調節(jié)IL-6,IL-10炎性介質的轉錄、合成,從而起到器官功能保護的作用。
[Abstract]:Aim: to investigate the molecular and pathophysiological mechanisms of hypervolemic hemofiltration combined with early fluid resuscitation in the protection of organ dysfunction caused by septic shock. Participants: healthy Yorkshire domestic pigs (23-25kg) methods: 18 pigs were randomly divided into two groups: the control group and the control group. 50ug/ (kg.h) was used to dilute lipopolysaccharide (LPS) of Escherichia coli to induce septic shock model, then the blood pressure was guaranteed by fluid resuscitation and vasoactive drugs. Routine flow hemofiltration (CRRT 25 ml / (kg.h) and high volume hemofiltration (HVHF 85 ml / (kg.h) were treated. The indexes of PICCO, the dosage of vasoactive drugs and the duration of maintenance were monitored. The concentrations of IL-6 and IL-10 in plasma, the relative expression of NF-kappa B mRNA in the main organs and the pathological sections were detected. Results: early high volume hemofiltration could significantly reduce the expression of NF-kappa B in tissues and organs, decrease the level of plasma inflammatory factors, reduce the dosage and maintenance time of vasoactive drugs, and alleviate the damage of tissues and organs. Conclusion: the overexpression of NF-kappa B and inflammation play an important role in multiple organ dysfunction. HVHF can regulate the transcription and synthesis of IL-6 and IL-10 by inhibiting the overexpression of NF-kappa B. Thus play the role of organ function protection.
【學位授予單位】：揚州大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7

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