早期高容量血液滤过（HVHF）对感染性休克器官功能保护机制的实验研究

发布时间：2018-07-12 19:17

本文选题：高容量血液滤过 + 感染性休克　；参考：《扬州大学》2013年硕士论文

【摘要】：目的：探讨高容量血液滤过联合早期液体复苏对感染性休克造成的器官功能障碍的保护作用的分子及病理生理机制。研究对象：健康约克夏家猪(体重23-25kg) 方法： 18只猪随机分为对照组、CRRT组和HVHF组。使用50ug/(kg.h)稀释大肠埃希氏菌脂多糖(LPS)持续静脉泵人,诱导感染性休克模型,然后经过液体复苏及血管活性药物维持保证组织灌注血压水平,分别给与常规治疗、常规流量血液滤过(CRRT25ml/(kg.h))以及高容量血液滤过(HVHF85ml/(kg.h))治疗。监测每组的血流动力学指标,PICCO监测指标,血管活性药物用量及维持时间,测定血浆中IL-6, IL-10的浓度,检测各主要脏器的NF-kappa B中mRNA的相对表达量以及进行病理组织切片检查。结果：早期高容量血液滤过能够明显降低组织器官NF-kappa B的表达水平,有效降低血浆炎性因子水平,减少血管活性药物的用量及维持时间,减轻组织器官的损害。结论： NF-kappa B的过度活化以及炎症反应在多脏器功能损害中起着重要的作用,HVHF能够通过抑制NF-kappa B的过度活化,调节IL-6,IL-10炎性介质的转录、合成,从而起到器官功能保护的作用。
[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.
【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7

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