限制性液体复苏对失血性休克大鼠早期肺损伤保护作用的研究

发布时间：2018-08-06 21:53

【摘要】：目的:探讨限制性液体复苏方式对未控制出血的失血性休克大鼠肺组织形态、炎症反应及细胞凋亡的影响。主要通过比较限制性液体复苏与常规液体复苏之间各组NF-k B及ICAM-l的表达、肺HE染色后光镜下观察肺的病理损伤程度和肺组织细胞凋亡数量的不同,得出限制性液体复苏对早期失血性休克大鼠肺组织的保护作用,从病理生理的角度判断限制性液体复苏方案对失血性休克大鼠早期复苏的效果,为进一步的临床应用提供理论基础。方法:将60只SD大鼠制作成失血性休克模型,随机分为假手术对照组(C)、限制性液体复苏组(LR)、常规液体复苏组(TR)、未复苏组(NR),每组15只,分别行不同处理方式,在复苏结束后的第120min采血并处死大鼠,行肺组织取样,光镜下观察肺组织病理学变化,采用酶联免疫吸附法(ELISA)检测大鼠肺组织NF-k B表达,免疫组化检测肺组织ICAM-1表达,末端脱氧核苷酸转移酶介导的原位末端标记法(TUNEL)检测检测肺组织细胞凋亡情况。结果:实验结果示:在肺组织病理性损伤,NF-k B、ICAM-1表达及细胞凋亡测定四方面,限制性液体复苏(LR)组和常规液体复苏(TR)组均高于对照组(C)组,并显著低于未复苏(NR)组(P0.01);LR组比TR组病理性损伤和细胞凋亡水平要低,两者之间统计学差异显著(P0.01);LR组比TR组NF-k B、ICAM-1表达水平要低,且两者之间有统计学差异(P0.05)。结论:限制性液体复苏可降低失血性休克大鼠NF-k B、ICAM-1的表达,减轻肺组织病理性损伤及肺组织细胞凋亡程度,可能对肺损伤起到一定的保护作用。
[Abstract]:Objective: To investigate the effects of restrictive fluid resuscitation on lung tissue morphology, inflammatory response and apoptosis in rats with hemorrhagic shock without control bleeding. The expression of NF-k B and ICAM-l in each group was mainly compared with conventional fluid resuscitation, and the degree of lung pathological damage and lung tissue were observed under the light microscope after HE staining. The protective effect of restrictive liquid resuscitation on the lung tissue of rats with early hemorrhagic shock was obtained, and the effect of restrictive liquid resuscitation on the early recovery of hemorrhagic shock in rats was judged from the pathophysiological point of view, and the basis for further clinical application was provided. Methods: 60 SD rats were made into blood loss. The model of sexual shock was randomly divided into the sham operation control group (C), the restrictive fluid resuscitation group (LR), the routine fluid resuscitation group (TR) and the non resuscitation group (NR), with 15 rats in each group. The blood samples were collected at 120min after the end of the resuscitation and the rats were executed, the lung tissue samples were taken, the pathological changes of lung tissue were observed under light microscope, and the enzyme linked immunosorbent assay was used. The expression of NF-k B in lung tissue of rats was detected by ELISA, and the expression of ICAM-1 in lung tissue was detected by immunohistochemistry. The apoptosis of lung tissue was detected by terminal deoxynucleotidyl transferase mediated in situ terminal labeling (TUNEL) detection. Results: experimental results showed that four aspects of pathological damage in lung tissue, NF-k B, ICAM-1 expression and apoptosis determination were limited. The sex liquid resuscitation (LR) group and the routine liquid resuscitation (TR) group were all higher than the control group (C), and significantly lower than the non resuscitation group (NR), and the pathological injury and apoptosis level in the LR group were lower than those in the TR group, and the statistical difference between the two groups was significant (P0.01), and the LR group was lower than the TR group NF-k B, and there was a statistically significant difference between the two groups. Conclusion: restrictive fluid resuscitation can reduce the expression of NF-k B and ICAM-1 in rats with hemorrhagic shock, reduce the pathological damage of lung tissue and the degree of apoptosis of lung tissue, and may play a protective role in the lung injury.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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