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肠黏膜屏障的影响

发布时间：2018-05-11 09:36

本文选题：休克 + 出血性　；参考：《重庆医学》2017年35期

【摘要】：目的观察丙酮酸盐替代乳酸盐腹膜透析液行腹腔复苏对失血性休克家兔肠黏膜屏障的影响。方法雄性健康家兔48只以Wiggers改良方法制备失血性休克模型,将其分为常规静脉复苏组(A组)、常规静脉复苏+腹腔注射乳酸盐腹膜透析液组(B组)、常规静脉复苏+腹腔注射丙酮酸盐腹膜透析液组(C组)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组)。检测休克前、休克后60min及复苏后60、180min静脉血二胺氧化酶(DAO)和脂多糖(LPS)水平。于观察终点取距回盲部5cm的一段回肠,测定组织干/湿质量比、丙二醛(MDA)水平及超氧化物歧化酶(SOD)活性,并观察其病理形态学改变。结果 4组休克前血浆DAO、LPS水平比较,差异均无统计学意义(P0.05);休克后60min均较休克前升高,但组间比较差异均无统计学意义(P0.05);复苏后60、180min,A、B、C、D组血浆DAO、LPS水平依次降低(P0.05)。复苏后180min,A、B、C、D组回肠组织MDA水平依次降低(P0.05),SOD活力水平、组织干/湿质量比依次升高(P0.05),且组织损伤程度也依次减轻。结论丙酮酸盐替代乳酸盐腹膜透析液腹腔复苏可更有效地保护失血性休克家兔肠组织细胞和减轻肠黏膜损伤。
[Abstract]:Objective to observe the effect of intraperitoneal resuscitation with pyruvate instead of lactate peritoneal dialysis on intestinal mucosal barrier in rabbits with hemorrhagic shock. Methods 48 healthy male rabbits were used to establish hemorrhagic shock model by modified Wiggers method. It was divided into group A, group B, group B and group C (intraperitoneal injection of lactate peritoneal dialysis solution) and intravenous pyruvate solution resuscitation (group C). Group D was given pyruvate peritoneal dialysis solution intraperitoneally. The levels of 60min and lipopolysaccharide (LPS) were measured before and after shock and 60180min after resuscitation. At the end point, the ileum from the ileocecal part was taken. The dry / wet mass ratio, malondialdehyde (MDA) level and the activity of superoxide dismutase (SOD) were measured, and the pathomorphological changes were observed. Results there was no significant difference in plasma Daemon LPS levels in the four groups before shock, but there was no significant difference in 60min levels between the four groups after shock, but there was no significant difference between the two groups, and the plasma DAON lipopolysaccharide level decreased in turn at 60180 min after resuscitation. After resuscitation, the level of MDA in ileum of group D decreased in turn, the ratio of dry to wet weight increased in turn, and the degree of tissue damage was reduced in turn. Conclusion Peritoneal resuscitation with pyruvate instead of lactate peritoneal dialysis solution can more effectively protect intestinal tissue cells and reduce intestinal mucosal injury in rabbits with hemorrhagic shock.
【作者单位】：湖北医药学院附属人民医院麻醉科;三峡大学仁和医院麻醉科;
【基金】：国家自然科学基金资助项目(81201460)
【分类号】：R459.7

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