多巴胺和去甲肾上腺素对脓毒症休克兔急性肺损伤的保护作用

发布时间：2018-04-29 03:04

本文选题：脓毒症休克 + 急性肺损伤　；参考：《南京医科大学学报(自然科学版)》2014年05期

【摘要】：目的:评价多巴胺和去甲肾上腺素对脓毒症休克兔急性肺损伤的保护作用。方法:采用盲肠结扎穿孔(CLP)联合静脉注入内毒素的方法复制脓毒症休克动物模型,将63只新西兰大白兔分为假手术对照组(A组,n=7)、模型组(B组,n=14)、多巴胺治疗组(C组,n=14)、去甲肾上腺素治疗组(D组,n=14)、多巴胺联合去甲肾上腺素治疗组(E组,n=14),各组分别于造模后3、6 h处死7只。留取血清标本,用酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)检测各时相点血清中肺泡表面活性蛋白A与肺泡表面活性蛋白D(surfactant protein A and surfactant protein D,SP-A and SP-D)的浓度值,并留取肺组织标本做光镜和电镜检查。结果:各组血清中SP-A与SP-D的浓度值在各时相点均高于A组(P0.05);与B组比较,C组血清中SP-A与SP-D的浓度值在3、6 h差异均无统计学意义(P0.05);D、E组血清中SP-A与SP-D的浓度值在3、6 h均显著低于B组(P0.05)。形态学观察发现D、E组肺组织损伤明显轻于B、C组。结论:脓毒症休克时肺组织损伤严重;单独应用去甲肾上腺素或联合应用去甲肾上腺素和多巴胺可以有效减轻脓毒症休克引起的肺组织损伤,对肺组织起保护作用。
[Abstract]:Aim: to evaluate the protective effects of dopamine and norepinephrine on acute lung injury in septic shock rabbits. Methods: septic shock model was established by cecal ligation and perforation combined with intravenous injection of endotoxin. 63 New Zealand white rabbits were divided into sham operation control group (group A), model group B (group B), dopamine group C (group C), noradrenaline group (group D), and dopamine plus norepinephrine treatment group (group E). 7 rats were killed at 6 hours after the model. Serum samples were collected and the concentrations of alveolar surfactant protein A and alveolar surfactant protein D(surfactant protein A and surfactant protein SP-A and SP-D were detected by enzyme-linked immunosorbent assaysa at different time points. The specimens of lung tissue were examined by light microscope and electron microscope. Results: the concentration of SP-A and SP-D in serum of each group was higher than that of group A at each time phase, and the concentration of SP-A and SP-D in group C was not significantly different from that in group B at 3h. There was no significant difference in the concentration of SP-A and SP-D between group A and group C at 36 h. All of them were significantly lower than group B (P 0.05). Morphological observation showed that the lung tissue injury in DU E group was significantly lighter than that in BU C group. Conclusion: the lung tissue injury is serious in septic shock and norepinephrine alone or combined with norepinephrine and dopamine can effectively attenuate the lung tissue injury induced by septic shock and play a protective role in the lung tissue.
【作者单位】：南京医科大学附属南京医院急诊科;
【基金】：南京市卫生局重大项目(2007-3-7)
【分类号】：R563.8

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