【摘要】：目的：探究用不同液體復(fù)蘇失血性休克大鼠后，不同時(shí)間點(diǎn)其骨髓中髓系抑制性細(xì)胞(myeloid-derivedsuppressorcells,MDSCs)的數(shù)量變化情況。 方法：采用股動(dòng)脈放血方法建立失血性休克大鼠模型，在液體復(fù)蘇早期階段懫用乳酸林格氏液、晶膠液、7.5%高滲氯化鈉三種不同液體復(fù)蘇，其后為自體血液回輸階段，在復(fù)蘇成功后12h、24h和48h三個(gè)時(shí)間點(diǎn)用脊髓離斷法處死大鼠，同時(shí)設(shè)假手術(shù)組正常對(duì)照組。處死后，獲取大鼠骨髓細(xì)胞懸液，采用流式細(xì)胞技術(shù)觀察大鼠骨髓中髓系抑制性細(xì)胞的數(shù)量隨時(shí)間變化的情況。 結(jié)果： 1.假手術(shù)組骨髓中MDSCs含量隨時(shí)間的延長(zhǎng)無(wú)明顯差異，采用單因素方差分析，，無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）；乳酸林格氏液組、晶膠液組和高滲氯化鈉組各組骨髓中MDSCs含量24小時(shí)時(shí)間點(diǎn)較12小時(shí)時(shí)間點(diǎn)升高，48小時(shí)時(shí)間點(diǎn)較24小時(shí)時(shí)間點(diǎn)降低，12小時(shí)與48小時(shí)骨髓中MDSCs含量相近似，無(wú)統(tǒng)計(jì)學(xué)差異（P0.05）。 2.與假手術(shù)組相比，各時(shí)間點(diǎn)的乳酸林格氏液組、晶膠液組及高滲氯化鈉組骨髓中MDSCs所占的比例均發(fā)生明顯變化，且具有統(tǒng)計(jì)學(xué)差異（P0.05）； 3.乳酸林格氏液組、晶膠液組及高滲氯化鈉組三組間比較，高滲氯化鈉組較乳酸林格氏液組和晶膠液組均明顯降低，有統(tǒng)計(jì)學(xué)意義（P0.05），乳酸林格氏液組和晶膠液組之間骨髓中MDSCs含量較為接近，無(wú)明顯差異，無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。 結(jié)論： 1．失血性休克早期液體復(fù)蘇后，大鼠骨髓中MDSCs的數(shù)量隨時(shí)間的延長(zhǎng)先升高后降低，說(shuō)明液體復(fù)蘇可能適度抑制MDSCs的數(shù)量。 2．與乳酸林格氏液、晶膠液相比，高滲鹽溶液復(fù)蘇失血性休克時(shí)，能夠更有效抑制骨髓中MDSCs的數(shù)量，對(duì)失血性休克后的免疫調(diào)節(jié)作用較強(qiáng)。
[Abstract]:Aim: to investigate the changes of the number of myeloid inhibitory cells (myeloid-derivedsuppressorcells,MDSCs) in bone marrow of hemorrhagic shock rats resuscitated with different fluids at different time points. Methods: the rat model of hemorrhagic shock was established by femoral artery bleeding. In the early stage of fluid resuscitation, the rats were resuscitated with three different fluids: Ringer's lactate solution, crystal glue solution and 7.5% hypertonic sodium chloride, followed by autologous blood transfusion. The rats were killed by spinal cord amputation at 24 h and 48 h after successful resuscitation, and the sham operation group was set up as normal control group. After the rats were killed, bone marrow cell suspension was obtained. Flow cytometry was used to observe the changes of the number of medullary inhibitory cells in rat bone marrow with time. Results: 1. There was no significant difference in bone marrow MDSCs content with the prolongation of time in sham-operation group, but there was no statistical significance by univariate ANOVA (P0.05). The MDSCs content in bone marrow of Ringer's lactate group, crystal gel solution group and hypertonic sodium chloride group was higher than that of 12 hour time point, but decreased at 48 hours time point, and was similar to that of 48 hour bone marrow. There was no statistical difference (P0.05). 2. Compared with sham operation group, the percentage of MDSCs in bone marrow of Ringer's lactate group, crystal gel solution group and hypertonic sodium chloride group were significantly different at each time point (P0.05); Compared with Ringer's lactate solution group, crystal gel solution group and hypertonic sodium chloride group, hypertonic sodium chloride group was significantly lower than that of lactate Ringer's liquid group and crystal gel solution group (P0.05). The content of MDSCs in bone marrow of Ringer's lactate group and crystal gel group was similar, no significant difference (P0.05). Conclusion: 1. After early fluid resuscitation in hemorrhagic shock, the number of MDSCs in bone marrow of rats increased first and then decreased with the prolongation of time, indicating that fluid resuscitation may moderately inhibit the amount of MDSCs. 2. 2.Compared with Ringer's lactate solution and crystal gel solution, hyperosmotic salt solution was more effective in inhibiting the amount of MDSCs in bone marrow during hemorrhagic shock resuscitation, and had stronger immunomodulation effect after hemorrhagic shock.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R459.7

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