不同复苏液对创伤失血性休克大鼠血浆及肺组织TNF-α、IL-6及MPO的影响

Effects of various resuscitation fluids on expression of plasma and lung TNF-α,IL-6 and lung MPO during traumatic shock in rats

目的探讨大鼠创伤失血性休克复苏时使用25%白蛋白与乳酸林格液对早期肺损伤的影响及可能机制.方法 45只SD大鼠随机分为3组,假手术(Sham)组、林格液(RL)组和白蛋白(ALB)组复苏后2 h取血并处死动物取肺组织测定TNF-α、IL-6表达及髓过氧化酶(MPO)活性和肺湿/干重(肺W/D)比值.结果各实验组休克复苏2 h后血浆及肺泡灌洗液TNF-α、IL-6表达以及肺组织MPO活性、肺W/D比值均较Sham组高(P<0.05);ALB组复苏后维持MAP80～90 mmHg所需液体较RL组明显减少(P<0.05);ALB组复苏后血浆及肺泡灌洗液TNF-α、IL-6表达以及肺组织MPO活性、肺W/D比值均较RL组低(P<0.05).结论大鼠创伤失血性休克时血浆及肺组织TNF-α、IL-6表达及MPO活性增高,白蛋白复苏较乳酸林格液复苏肺组织损伤减轻.

Objective To investigate the changes of plasma and lung TNF-α,IL-6 and lung MPO during traumatic shock in rats and therapeutic effects of Ringer's lactate and 25% albumin in traumatic shock in rats.Methods 45 rats were divided into 3(Sham,Ringer's lactate and 25% albumin) groups randomly.RL group and ALB group were subjected to traumatic shock for 1h,followed by resuscitation to a controlled mean blood pressure with Ringer' lactate and 25% albumin for 2 h.After resuscitation,plasma TNF-α,IL-6 were measured.The animals were then killed and lung were excised for measuring TNF-α,IL-6,MPO and Wet/Dry weight ratio.Results Plasma and lung concentrations of TNF-α,IL-6 and lung MPO,Wet/Dry weight ratio were significantly higher in the RL and ALB treated groups, compared with the Sham group(P<0.05).The volume of fluids required was significantly smaller in the albumin treated group than in the Ringer's lactate group(P<0.05).The levels of plasma and lung TNF-α,IL-6 and lung MPO and Wet/Dry weight ratio were lower in ALB group compared with the RL group(P<0.05).Conclusion This study suggests that expression of plasma and lung TNF-α,IL-6 and lung MPO are increased in traumatic shock in rats. 25% albumin caused lower expression of plasma and lung TNF-α,IL-6 and lung MPO than single use of Ringer's lactate.Resuscitation with 25% albumin may have utility in reducing lung injury after traumatic shock in rats.