创伤性休克兔血浆一氧化氮、TNF-α、IL-6和血流动力学的动态变化及亚甲蓝的干预作用

Dynamic changes of plasma nitric oxide,TNF-α,IL-6 and hemodynamics in rabbits with traumatic shock and the intervention of methylene blue

目的观察创伤性休克兔血浆一氧化氮(nitric oxide,NO)、TNF-αI、L-6和血流动力学的动态变化及亚甲蓝(Methylene Blue,MB)的干预作用。方法选用大家兔18只,随机分为3组(对照组、创伤性休克生理盐水复苏组及创伤性休克MB处理组),每组6只,记录休克前(T1)、休克末(T2)、复苏末(T3),复苏后0.5h(T4)、2h(T5)、4h(T6)时间点收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)及心率(HR)的变化,并测定血浆NO、TNF-α及IL-6的水平。结果兔创伤性休克后,血浆NO、TNF-α及IL-6水平明显高于休克前,生理盐水复苏组动物复苏后血浆NO、TNF-α及IL-6进行性增高,复苏后血压维持较为困难;MB处理组动物复苏后血浆NO、TNF-α及IL-6水平明显降低,复苏后血压维持满意;对照组各时间点血浆NO、TNF-αI、L-6及血流动力学无明显变化。结论NO、TNF-α及IL-6在创伤性休克的病理发展过程中起着重要作用,应用MB可降低血浆NO、TNF-α及IL-6的水平,稳定血流动力学,有助于创伤性休克的纠正。

Objective To observe the changes of plasma nitric oxide, tumor necrosis factor alpha （TNF-α） ,interleu- kin-6（IL-6） and hemodynamics in rabbits with traumatic shock and the intervention of methylene blue （MB）. Methods Eighteen rabbits was randomly assigned into 3 groups （ n = 6）, namely control group, traumatic shock resuscitation with normal saline group （NS group） and traumatic shock resuscitation with methylene blue group （MB group）. The systolic blood pressure （SBP） , diastolic blood pressure （DBP） , mean arterial pressure （MAP） and heart rate （HR）were recorded, and NO, TNF-α and IL-6 of plasma were measured, at pre-shock, tele-shock,tele-resuscitation,0.5 hour,2 hours and 4 hours after resuscitation. Results The levels of plasma NO, TNF-α and IL-6 in rabbits after traumatic shock were very higher than pre-shock. In NS group, the levels of plasma NO, TNF-α and IL-6 after resuscitation were progressively increased, and the blood pressure after resuscitation was unstable. But in MB group, the levels of plasma NO, TNF-α and IL- 6 after resuscitation were obviously decreased, and the blood pressure after resuscitation was very stable. In control group, the levels of plasma NO,TNF-α, IL -6 and hemodynamics had no changes among all courses. Conclusions NO, TNF-α and IL-6 play important roles in the pathological process of traumatic shock, and the application of MB after resuscitation can decrease plasma NO ,TNF-α and IL-6 levels and ameliorate hemodynamics. MB may improve the condition of traumatic chock.