小剂量羟乙基淀粉对脓毒症大鼠的肺保护作用研究

Study on Protective Effects of Low-dose Hydroxyethyl Starch on Lungs of Rats With Sepsis

目的研究小剂量羟乙基淀粉130/0.4(HES)对脓毒症模型大鼠肺毛细血管通透性以及全身及局部炎症细胞因子水平的影响。方法 40只雄性SD大鼠,随机分为小剂量组(S组)、大剂量组(L组)、脓毒症对照组(SC组)及假手术对照组(C组)4组,每组10只。S组、L组及SC组均采用盲肠结扎穿孔的方法建立脓毒症大鼠模型;分别于CLP后4h时静脉输注HES 5ml/kg+生理盐水25ml/kg、HES 30ml/kg,SC组于相应时点输注生理盐水30ml/kg。CLP后6h处死大鼠,取肺组织计算含水量,测定毛细血管通透性、炎症细胞因子肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平及外周血炎症细胞因子水平。结果与C组比较,S组、L组及SC组肺含水量、毛细血管通透性均明显增高,肺组织及外周血TNF-α、IL-1β、IL-6水平增高(P<0.05)。与SC组比较,S组与L组肺含水量、毛细血管通透性均有降低,肺组织及外周血TNF-α、IL-1β、IL-6水平降低(P<0.05);与S组比较,L组TNF-α、IL-1β、IL-6水平有所降低,但无统计学差异。结论小剂量羟乙基淀粉130/0.4具有一定肺保护作用。

Objective This study aimed to investigate the effects of low-dose hydroxyethyl starch（HES 130/0.4） on pulmonary capillary permeability and expression of systemic and local inflammatory cytokines in a rat model of sepsis. Methods A total of 40 male SD rats weighing 240-320 g were randomly divided into 4 groups （n = 10） .. group S （low dose HES group） ; group L （large dose HES group） ; group SC （sepsis control group） ; group C （sham operation group）. In group C, abdomen was opened and closed; in group S, L, SC, sepsis was induced by cecal liga- tion and puncture（CLP） ; HES 5ml/kg -[-saline 25ml/kg, HES 30 ml/kg, saline 30 ml/kg were infused on 4 hours after CLPI the animals were killed at 6 hours after CLP for the measurement of water content and the pulmonary capillary permeability of the lung; the inflammatory cytokines （TNF-α, IL-1β and IL-6） levels were measured in the systemic circulation and in the lung. Results The water content and the pulmonary capillary permeability of the lung were significantly higher in group S, L and SC when compared with group C, as well as systemic and local inflamma- tory cytokines （TNF-α, IL-1β and IL-6） levels（P〈0.05）. Infusion of different volumes of HES 130/0.4 decreased the water content and the pulmonary capillary permeability of the lung and the systemic and local inflammatory cyto- kines（P〈0.05）. Compared with group S, group L showed more obvious decrease of water content and the pulmona- ry capillary permeability of the lung and the systemic and local inflammatory cytokines, while without statistical sig- nificance. Conclusion Low-dose hydroxyethyl starch showed some protective effects on lungs of rats with sepsis.