乌司他丁对创伤失血性休克兔肺损伤的保护作用

Protective effects of ulinastatin on ischemia/reperfusion injury in the rabbit lung in traumatic hemorrhagic shock

目的 探讨乌司他丁对肺缺血-再灌注损伤的保护作用及其机制。方法 新西兰白兔30只,随 机分为假手术对照组、创伤失血性休克组和乌司他丁治疗组。动物模型用经股动脉放血使平均动脉压降至 (40±5)mm Hg(1 mm Hg=0.133 kPa).维持90 min后回输全部失血及等量乳酸林格液进行复苏。复苏后4 h 测定肺组织髓过氧化物酶(MPO)、肺泡灌洗液中中性粒细胞弹性蛋白酶(BALF-NE)活性、肺叶湿／干重比 及肺组织病理学改变。结果 休克组和乌司他丁治疗组MPO含量、BALF-NE活性以及湿／干重比均较假手 术对照组显著增高(P均<0.05),乌司他丁治疗组各指标均明显低于休克组(P均<0.05)。结论 蛋白酶抑 制剂乌司他丁在创伤失血性休克时能够抑制肺MPO和NE活性,降低肺组织湿／干重比,减轻缺血-再灌注 后的肺损伤。

Objective To investigate the effects and mechanisms of ulinastatin on activities of myeloperoxidase(MPO) in lung tissue and neutrophil elastase(NE) in bronchoalveolar lavage fluid and to evaluate the protective effects of ulinastatin on rabbit lung in traumatic hemorrhagic shock. Methods Thirty rabbits were randomly assigned to three groups: control group, traumatic hemorrhagic shock group and ulinastatin - treatment group. The traumatic hemorrhagic shock model was reproduced by producing femur fracture and femoral artery bleeding to reduce the mean artery pressure to (40±5) mm Hg(1 mm Hg= 0.133 kPa). The hypotension was maintained 90 minutes before the shed blood and equivalent amount of Ringer's lactate was infused. Four hours after blood volume compensation, the activities of MPO in lung tissue and NE in bronchoalveolar lavage fluid (BALF) were measured, and the extravascular lung water volume was determined. Results Compared with control group, the activities of either MPO in lung tissue or NE in BALF appeared to be increased in the ulinastatin -treatment group (both P<0. 05), but their levels were significantly higher in traumatic hemorrhagic shock group (both P<0. 05). The extravascular lung water volume was increased significantly in the two experimental group (both P<0. 05), however it was more pronounced in traumatic hemorrhagic shock group (all P<0. 05). Conclusion Ulinastatin can inhibit the increase in the activities of MPO in lung tissue and NE in BALF, and possesses potential protective effects on the lung tissue in traumatic hemorrhagic shock.