红细胞-代血浆对失血性休克犬外周血单个核细胞核转录因子-κB活性的影响

Efficacy of plasma substitute mixed with RBCs on activity of nuclear factor-κB in peripheral blood mononuclear cells in treatment of hemorrhagic shock in dogs

目的评价红细胞-代血浆（贺斯）对犬失血性休克的疗效及其对外周血单个核细胞中核转录因子一KB（NF-κB）活性的影响。方法18只健康成年犬随机分成3组（n=6）：贺斯组（A组）、全血组（B组）和红细胞一贺斯组（C组）。采用Wiggers改良法制作犬可逆性休克模型，放血使平均动脉血压降至5．33～6．6kPa（40～50mmHg），并维持60min。各组以10mL·kg^-1·min^-1速率分别输注不同成分的液体进行治疗。分别于休克前、休克60min和休克治疗60min测血流动力学指标（MAP、HR、CO），同时检测外周血单个核细胞中NF-κB活性。结果（1）各组休克60min时血流动力学指标均明显低于休克前（P〈0．05），且各组外周血单个核细胞NF-κB活性均明显升高（P〈0．05）。（2）与休克60min比较，休克治疗60min时，各组血流动力学指标均有不同程度地恢复，外周血单个核细胞NF-κB活性均明显降低，其中红细胞一贺斯组恢复最佳（P〈0．05）。结论红细胞一贺斯能显著降低外周血单个核细胞NF-κB活性，达到良好的休克治疗效果。

Objective To evaluate the efficacy of plasma substitute mixed with RBCs on the activity of nuclear factor-κB in peripheral blood mononuclear cells in the treatment of hemorrhagic shock. Methods Eighteen healthy dogs of both sexes weighing 15 --20kg were randomized into 3 groups（6 cases each） ..hydroxyethyl starch group（group A）, whole blood group（group B）and RBC- hydroxyethyl starch group（group C）. Hemorhagic shock was produced according to Wigger＇s method, MAP was maintained at 40mm Hg for 60min by blood removal. Subsequently the dogs were resuscitated with hydroxyethyl starch or whole blood or RBC- hydroxyethyl starch for 60min. MAP, HR and cardiac output（CO） were monitored and recorded. Venous blood samples were taken for determination of the activity of nuclear factor-κB in peripheral blood mononuclear cells. Results （1） The hemodynamics were significantly decreased whereas HR was significantly increased and the activity of nuclear faetor-κB in peripheral blood mononuclear cells was increased significantly during shock in all 3 groups（P〈0.05）. （2） At 60min after resuscitation, the hemodynamics returned to pre-shock baseline level in all 3 groups especially in group C; the activity of nuclear factor-κB in peripheral blood mononuclear cells was decreased in all 3 groups especially in group C（P〈0.05）. Conclusion Plasma substitute mixed with RBCs has satisfactory anti-hemorhagie shock effect;it can decrease the activity of nuclear factor-κB in peripheral blood mononuclear cells.