限制性液体复苏对失血性休克大鼠炎症因子表达与免疫功能的影响

The expressions of inflammatory factors and immune function of limited fluid resuscitation on hemorrhagic shock in rats

目的探讨限制性液体复苏对失血性休克大鼠炎症因子表达与免疫功能的影响。方法健康雄性SD大鼠30只,随机分为空白组、对照组与实验组,每组10只;空白组不制作休克模型;失血性休克模型制作成功后,实验组给予限制性液体复苏,对照组给予大量液体复苏;在休克前(T0)、休克模型建立后(T1)与复苏后(T2)测定血液中炎症因子变化与免疫功能变化情况。结果空白组与实验组大鼠生存率都为100.0%,对照组大鼠死亡3只,生存率为70.0%,空白组与实验组大鼠生存率明显高于对照组(P<0.05)。实验组与对照组的抽样失血量都高于空白组(P<0.05),对照组的输液量也明显高于实验组(P<0.05)。三组T0时间点白细胞介素(IL)-4和IL-10对比差异无统计学意义(P>0.05),对照组T1与T2时间点IL-4和IL-10水平明显低于实验组与空白组(P<0.05),实验组与空白组差异无统计学意义(P<0.05)。实验组T0、T1、T2时间点CD4^+/CD8^+比值分别为1.98±0.42、2.00±0.56与1.92±0.63,对照组分别为1.92±0.45、1.54±0.42和1.11±0.32,实验组T1、T2时间点CD4^+/CD8^+比值明显高于对照组(P<0.05),与空白组对比差异无统计学意义(P>0.05)。结论失血性休克大鼠早期复苏应用限制性液体复苏能促进IL-4、IL-10释放,纠正免疫功能紊乱,降低大鼠死亡率,减少输液量,有很好的应用价值。

Objective To investigate the expressions of inflammatory factors and immune function of limited fluid resuscitation on hemorrhagic shock in rats. Methods 30 healthy male SD rats were randomly divided into blank, control and experimental groups with 10 rats in each group. After constructing hemorrhagic shock model, the experimental group was treated with limited fluid resuscitation, the con- trol group was given large amount of liquid in the recovery; the changes of inflammatory factors and immune function were measured at time points before the shock （T0）, shock model （T1） and resuscitation （T2）. Results The survival rates in blank and experimental groups were 100%, which were significantly higher than those of control group （70.0% , P〈0.05 ）. Tile blood loss of experimental and control groups was higher than that of blank group （P〈0.05）, and it was significantly higher in control group than that of experimental group （ P〈 0.05 ）. The levels of IL-4 and IL-10 in three groups had no significant differences at TO time point （ P〉0.05 ） , and the levels of IL-4 anti IL-10 in control group at T1 and T2 time points were significantly lower than those of experimental and control groups （ P〈0.05 ）. Tile ratio of CIM＊/CD8~ of experimental group at T1 and T2 time points were significantly higher than those of control group （P〈0.05）. Conclusions The limited fluid resuscitation on early resuscitation of hemorrhagic shock in rats could promote the release of IL-4 and IL-10, it could cor rect the disorder of immune function, so as to reduce the mortality of rats and the amount of infusion.