失血性休克复苏延迟兔模型的构建

Construction of a Rabbit Model with Prolonged Hemorrhagic Shock

目的探讨失血性休克复苏延迟兔模型的构建方法。方法选择30只雄性新西兰大白兔,通过血压控制放血法构建失血性休克复苏延迟兔模型,随机将其分为3组,每组各10只,依据休克期控制平均动脉压（MAP）分组,MAP分别为40-50 mm Hg（轻度失血性休克组）、30-40 mm Hg（中度失血性休克组）、20-30 mm Hg（重度失血性休克组）。观察3组能否维持180 min休克状态,并观察比较放血开始时间点（T1）、失血性休克维持期结束时间点（T2）和观察结束时间点（T3）的MAP和肿瘤坏死因子（TNF-α）水平。结果失血性休克复苏延迟兔模型均成功建立。重度失血性休克组在休克维持中后期全部死亡,未能实现复苏延迟;轻、中度失血性休克组在成功维持休克状态180 min后均进行了液体复苏。T1时3组MAP比较差异无统计学意义（P〉0.05）;T2、T3时MAP轻度失血性休克组均高于中度失血性休克组,差异均有统计学意义（P〈0.05）。在T1时,轻、中度失血性休克组血清TNF-α水平比较差异无统计学意义（P〉0.05）;在T2和T3时均显著升高,组间每一时段两两比较差异均有统计学意义（P〈0.05）;轻度失血性休克组血清TNF-α水平明显低于中度失血性休克组（P〈0.01）。结论失血性休克期MAP控制在30 mm Hg以上可以成功构建发生严重全身系统性炎症反应的失血性休克复苏延迟（180 min）兔模型。

Objective To explore the construction of a rabbit model with prolonged hemorrhagic shock. Methods30 male New Zealand white rabbits were randomly divided into three groups（ n = 10,each group） based on the predetermined mean artery blood pressure（ MAP） levels： Mild shock group（ 40-50 mm Hg）,moderate shock group（ 30-40 mm Hg） and severe shock group（ 20-30 mm Hg）. We observed to see if the hemorrhagic shock states were all prolonged to 180 min in the three groups before conventional fluid resuscitation,and the levels of MAP and the systemic inflammation at the beginning of the shock（ T1）,at the end of hemorrhagic shock maintenance（ T2） and at the end of the experiment（ T3） respectively.Results The hemorrhagic shock was successfully prolonged to 180 min in both the mild and moderate shock groups,but all the rabbits of severe shock group were dead in the middle or later periods of the shock maintenance state. At T1,MAP of the three groups showed no significant difference（ P〈0. 05）; the MAP of mild shock group was statistically higher than that of moderate shock group at T2 or T3 respectively（ P〈0. 05）. In the mild and moderate hemorrhagic shock groups,serum TNF-α levels was not different at T1（ P〈0. 05）,but significantly increased at T2 and T3 respectively（ P〈0. 05）,and reached the highest level respectively at T3. At the same time,serum TNF-α levels in mild hemorrhagic shock group was significantly lower than that of the moderate hemorrhagic shock group at T2 and T3 respectively（ P〈0. 01）. Conclusion The prolonged hemorrhagic shock（ 180 min） animal model can be successfully constructed with New Zealand rabbits,in which the shock MAP can be maintained above 30 mm Hg and severe systemic inflammation can be observed.