丙酮酸盐替代乳酸盐腹膜透析液腹腔复苏对失血性休克家兔肝脏功能的影响

发布时间：2018-07-15 08:56

【摘要】：目的观察以丙酮酸盐替代乳酸盐腹膜透析液腹腔复苏对失血性休克家兔肝脏功能的影响。方法 48只失血性休克家兔随机分为常规静脉复苏组(A)、常规静脉复苏+腹腔注射乳酸盐腹膜透析液组(B)、常规静脉复苏+腹腔注射丙酮酸盐腹膜透析液组(C)和静脉丙酮酸盐液复苏+腹腔注射丙酮酸盐腹膜透析液组(D)。观察血流动力学变化,测定休克前、休克后60 min及复苏后60和180 min的ALT、AST含量。复苏180 min后取肝组织测定干/湿重比、MDA和SOD,并观察形态学变化。结果复苏后各组MAP都恢复至近基础水平,复苏180 min后A组MAP低于B、C、D三组(P0.05)。休克后,ALT、AST含量均较休克前明显升高,组间无差异(P0.05);复苏后,ALT、AST持续性下降,下降的幅度随A、B、C、D组依次加大(P0.05)。肝组织含水量及MDA含量随A、B、C、D组依次降低,而SOD活力则依次升高(P0.05),组织形态学损伤随之不断减轻。结论丙酮酸盐替代乳酸盐腹膜透析液腹腔复苏可更有效减轻失血性休克家兔的肝脏损伤。
[Abstract]:Objective to observe the effect of peritoneal resuscitation with pyruvate instead of lactate peritoneal dialysis on liver function in hemorrhagic shock rabbits. Methods Forty-eight rabbits with hemorrhagic shock were randomly divided into (A), group, conventional intravenous resuscitation group, intraperitoneal injection of lactate peritoneal dialysis solution group (B), routine intravenous resuscitation intraperitoneal injection of pyruvate peritoneal dialysate group (C) and intravenous resuscitation. Pyruvate solution was resuscitated by intraperitoneal injection of pyruvate peritoneal dialysis solution group (D). The changes of hemodynamics were observed and the alt AST levels before shock, 60 min after shock and 60 and 180 min after resuscitation were measured. After 180 min of resuscitation, liver tissue was taken to measure the dry / wet weight ratio of MDA and SOD, and the morphological changes were observed. Results after resuscitation, map of each group returned to near basic level, map of group A was lower than that of group D after 180 min of resuscitation (P0.05). After shock, the content of alt AST was significantly higher than that before shock, but there was no difference between the two groups (P0.05). The content of water and MDA in liver tissue decreased in turn, while the activity of SOD increased in turn (P0.05), and the damage of tissue morphology was alleviated. Conclusion Peritoneal resuscitation with pyruvate instead of lactate peritoneal dialysate can reduce liver injury more effectively in hemorrhagic shock rabbits.
【作者单位】：湖北医药学院附属人民医院麻醉科;三峡大学仁和医院;
【基金】：国家自然科学基金资助项目(编号:81201460)
【分类号】：R459.7

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