不同温度液体复苏对新西兰兔失血性休克模型肠系膜微循环功能及肠黏膜屏障功能影响

Effects of Different Fluid Resuscitation Temperatures on Mesenteric Microcirculation and Intestinal Mucosal Barrier Function in Hemorrhagic Shock Models of New Zealand Rabbits

目的探讨不同温度液体复苏对新西兰兔失血性休克模型肠系膜微循环功能及肠黏膜屏障功能影响。方法选取40只雄性新西兰兔,随机将其分为A、B、C和D组4组各10只,建立失血性休克模型。A、B和C组分别采用低温、常温和温热复苏液进行液体复苏,D组未行液体复苏。比较4组休克前(T1)、休克时(T2)、液体复苏1 h(T3)和液体复苏3 h(T4)时肠系膜微血管直径、红细胞流速及血清二胺氧化酶(DAO)、D-乳酸(D-LA)。结果肠系膜微血管直径和红细胞流速,与T1时比较,4组T2时均降低,A、B和D组T3时降低,D组T4时亦降低;与T2时比较,A、B和C组T3和T4时升高;与T3时比较,A和B组T4时升高(P<0.05)。肠系膜微血管直径,T3时C组最长,B、A和D组依次缩短;T4时A、B和C组均长于D组(P<0.05)。肠系膜微血管红细胞流速,T3时A、B和D组慢于C组,A和B组快于D组;T4时A、B和C组均快于D组(P<0.05)。与T1时比较,血清DAO和D-LA 4组T2、T3和T4时均升高;与T2时比较,A和B组血清DAO和D-LA T3和T4时升高,C组血清DAO T3时升高;与T3时比较,C组血清DAO和D-LA T4时降低(P<0.05)。血清DAO,T3时A和B组分别高于C和D组,C组高于D组;T4时A和B组分别高于C和D组(P<0.05)。血清D-LA,T3和T4时A和B组分别高于C和D组(P<0.05)。结论失血性休克可导致新西兰兔出现肠系膜微循环障碍及肠黏膜屏障功能异常,使用温热复苏液进行液体复苏利于改善肠系膜微循环,保护肠黏膜屏障功能。

Objective To investigate effects of different fluid resuscitation temperatures on mesenteric microcirculation and intestinal mucosal barrier function in hemorrhagic shock models of New Zealand rabbits.Methods Forty male New Zealand rabbits were selected and randomly divided into group A,B,C and D(n=10 in each group).The hemorrhagic shock models were established.Group A,B,and C were carried out liquid resuscitation with low temperature,normal temperature and warm resuscitation solution respectively,while group D did not undergo liquid resuscitation.Levels of mesenteric microvessels diameter,red blood cell(RBC)velocity and serum diamine oxidase(DAO)and D-lactic acid(D-LA)were compared before shock(T1),during shock(T2),after liquid resuscitation for 1 h(T3)and after liquid resuscitation for 2 h(T4)among four groups.Results Levels of mesenteric microvessels diameter and RBC velocity were decreased at T2 compared with those at T1 among four groups;the above indicators were decreased at T3 in group A,B and D,and the indicators were decreased at T4 in group D;the indicators at T3 and T4 were increased compared with those at T2 in group A,B and C,and the indicators at T4 were increased compared with those at T3 in group A and B(P<0.05).The diameter of mesenteric microvessels was the longest in group C at T3,followed by group B,A and D;at T4,the diameters in group A,B and C were longer than that in group D(P<0.05).At T3,erythrocyte velocity values of mesenteric microvessels in group A,B and D were slower than that in group C,but the values in group A and B were faster than that in group D;at T4,the velocity values in group A,B and C were faster than that in group D(P<0.05).Serum levels of DAO and D-LA were increased at T2,T3 and T4 compared with those at T1 among four groups;serum levels of DAO and D-LA at T3 and T4 were increased compared with those at T2 in group A and B,while DAO level at T3 was increased compared with that at T2 in group C;serum levels of DAO and D-LA at T4 were decreased compared with those at T3 in group C(P<0.05).Serum DAO levels in group A and B were respectively higher than with those in group C and D at T3,and the DAO level in group C was higher than that in group D;at T4,the levels in group A and B were respectively higher than those in group C and D(P<0.05).Serum levels of D-LA in group A and B were respectively higher than those in group C and group D at T3 and T4(P<0.05).Conclusion Hemorrhagic shock can lead to mesenteric circulation disturbance and intestinal mucosal barrier dysfunction in New Zealand rabbits.Liquid resuscitation with warm resuscitation solution is conducive to improving mesenteric microcirculation and protecting intestinal mucosal barrier function.