创伤/失血性休克后期肺损伤的性别差异

Gender dimorphism in lung injury after trauma/hemorrhagic shock

背景与目的我们以前的研究发现:创伤/失血性休克(T/HS)复苏后早期(3小时)肺损伤明显,雌性动物较雄性动物耐受性强。但是,T/HS后期肺损伤是否依然存在,是否具有性别差异目前仍然未知,本研究观察雌、雄动物T/HS后期肺损伤的差异。方法雌、雄性SD大鼠剖腹(创伤)后经颈动脉放血致T/HS或假休克(T/SS),90分钟后休克大鼠用乳酸林格氏液(RL)复苏;复苏后5天评估肺损伤的情况。结果T/HS后大鼠的肺通透性、肺髓过氧化物酶(MPO)水平以及支气管肺泡灌注液(BALF)蛋白浓度与血浆蛋白浓度的比值增加,雌性大鼠的上述变化与雄性大鼠相比更加显著。结论创伤/失血性休克5天后仍然存在肺损伤,而且有显著的性别差异,雌性大鼠肺损伤较雄性大鼠重。

Background and aims Previously We have documented that lung injury after trauma-hemorrhagic shock (T/HS) is significant 3 hours after resuscitation and that females are more resistant to T/HS-induced lung injury than males. However, it is not known if the lung injury and its gender dimorphrism still exsit 5 days after resuscitation. Therefore, We aim to determine the lung injury after T/HS and to compare its gender difference 5 days after resuscitation. Methods Male and female Sprague-Dawley rats were subjected to a midline laparotomy (trauma) and either hemorrhagic shock or sham shock. At the end of the shock period, the animals were resuscitated with Ringer lactate 3 times of their shed blood. Five days postresuscitation, the animals were sacrificed and lung permeability was measured . Results Lung permeability and pulmonary leukosequestration in T/HS animals were increased significantly 5 days In contrast to what seen 3 hours post-resuscitation, lung injury of female animals were more severe than male. That is, Females subjected to T/HS had increased pulmonary permeability, increased BALF protein/plasma protein ratio and increased pulmonary myeloperoxidase levels than males. Males gained while females lost body weight during study period. Conclusion Lung injury still can be seen 5 days aftar resuscitation. The injury is more severe in female than in male.