不同复苏方式对失血性休克大鼠脑组织SIOOB及糖基化终产物受体的影响

Influence of different resuscitation strategies on SIOOB and receptor of advanced glycation end - products （RAGE） in rat brain tissue after hemorrhagic shock

目的探讨不同复苏方式对未控制出血致失血性休克大鼠脑组织中晚期糖基化终产物受体（RAGE）及其配体S100B蛋白的影响。方法54只SD大鼠随机分成空白对照（C）组、限制性液体复苏（LR）组、常规液体复苏（TR）组，模拟未控制出血的失血性休克大鼠模型，进行不同方式的液体复苏，分别经历造模休克期、急救复苏期、止血治疗期、观察期，并在观察期1、6及12h采血、处死大鼠，检测各组大鼠脑组织S100B蛋白、RAGE含量以及血清丙二醛（MDA）和总超氧化物歧化酶（T—SOD）含量。结果在观察期1h，S100B蛋白及RAGE在LR组、TR组高于C组（P〈0．01），到了观察期6、12h，S100B蛋白含量比较为TR组〉LR组〉C组，且差异有统计学意义（P〈0．01）。而在观察期各个时间点，各组MDA在脑组织中含量比较均为LR组〉TR组〉C组，且各组之间比较差异有统计学意义（P〈0．01）。而同样在观察期各个时间点，各组T—SOD在脑组织中含量比较均为C组〉LR组〉TR组，且各组之间比较差异有统计学意义（P〈0．01）。结论限制性液体复苏同常规液体复苏模式相比可使失血性休克大鼠脑组织S100B蛋白的表达减缓，S100B蛋白及RAGE表达可能跟机体氧化应激水平或缺血一再灌注损伤相关。

Objective To explore the effect of different resuscitation strategies on advanced glycation end-products receptor （RAGE） and ligand S100B protein in brain tissue of the rats with hemorrhagic shock caused by uncontrolled bleeding. Methods 54 SD rats were randomly divided into blank control（C） group, limited fluid resuscitation （LR） group and traditional fluid resuscitation （TR） group. Rat models of hemorrhagic shock caused by uncontrolled bleeding were made, then we carried out different fluid resuscitation strategies through the shock stage, resuscitation period, hemostatic treatment period and the observation period. The rats were sacrificed in the observation period of 1, 6 and 12 h. Then SI00B, RAGE and serum malondialdehyde （MDA） and total superoxide dismutase （ T - SOD） content were detected in brain tissue of rats. Results In the observation period of 1 h, S100B protein and RAGE protein were higher in the LR group and TR group than in group C （ P 〈 0.01 ）. In the observation period of 6 and 12 h, S100B protein contents were TR group 〉 LR group 〉 C group, and the difference was statistically significant （ P 〈 0.01 ）. MDA contents in brain tissue were LR group 〉 TR group 〉 C group at various time points during the observation period. The T - SOD levels in brain tissue were C group 〉 LR group 〉 TR group, and the differences between groups were statistically significant （P 〈 0.01 ）. Conclusion The limited fluid resuscitation strategy of hemorrhagic shock in the rats can slow the expression of brain S100B compared with the traditional fluid resuscitation. The expression of S100B and RAGE protein may be related to the level of oxidative stress or ischemia - reperfusion injury.