减阻剂对急性失血性休克合并内毒素致伤二次打击大鼠血清细胞因子水平的影响

目的观察减阻剂对急性失血性休克合并内毒素致伤二次打击大鼠血清细胞因子水平的影响。方法60只SD大鼠，雌雄不拘，体质量（331±29）g，随机分为三组，每组20只。在30min内自颈动脉放血完成失血性休克，最终的指标为平均动脉压（40±5）mmHg，然后静脉给予内毒素10mg／kg，休克30min后开始液体复苏。复苏时间为5min，随后继续观察180rain。A组为对照组，静脉给予3．5ml／kg．的生理盐水；B组使用内含0．4mg／ml的透明质酸和0．05mg／ml聚氧化乙烯作为减阻剂的等量生理盐水复苏；C组复苏液为内含芦荟提取物0．05mg／ml的等量生理盐水。观察大鼠生存情况。在不同时间点测定大鼠血清细胞因子TNF-α、IL—1和IL-10水平的变化。结果A、B、C。C三组的生存率分别为20％、60％和65％。A组血清细胞因子TNF-α、IL-1和IL-10浓度均明显增加。与A组相比，减阻剂干预组（B和c组）TNF-α和IL-1水平显著降低（P〈0．01），同时IL．10水平明显增加（P〈0．01）。但B组和C组各时间点的细胞因子水平无显著性差异（P〉0．05）。结论在急性失血性休克复合内毒素二次打击大鼠模型中，减阻剂可提高大鼠生存率，此效果的作用机制之一可能是通过降低促炎性细胞因子TNF一仪、IL-1浓度和升高抗炎性细胞因子IL-10水平发挥的。

Effect of drag reducing polymer on serum cytokine levels in rats with two-hit model of combined acute severe hemorrhagic shock and endotoxin infusion

Objective To observe the effect of drag redaeJng polymer on serum cytokine levels in rats with two-hit model of combined acute severe hemorrhagic shock and endotoxin infusion. Methods Sixty SD rats of both sexes weighing （331 ± 29）g were randomly assigned to three groups of twenty animals in each group. The caudal vein was eannulated with polyethyleme tube to administer drugs and fluids. The rats were anesthetized with intravenously administered pentothal sodium 30 mg/kg intermittently. Right common carotid artery was eannulated for BP monitoring,blood removal and blood sampling. Acute evere hemorrhagic shock was induced by removal of blood in 30 rain and the aim of the shock was MAP（40 ±5）ram Hg. After that,endotoxin 10 mg/kg was given intravenously via the caudal vein. After 30 min＇s period of shock, resuscitation was carried out within 5 min：group A was control group,which resuscitated with 3.5 mL/kg normal saline ; group B resuscitated with 3.5 ml/kg of normal saline and hyaluronic acid（HA）0.4 mg/ml and polyethylene oxide（PEO） O. 05 mg/ml; group C resuscitated with 3.5 mL/kg normal saline and 0. 05 mg/ml DRP extracted from aloe vera. The survival time/rate of the rats were recorded. Arterial blood samples Were taken at different time points for determination of TNF-α, IL-1 and IL-IO concentrations. Results The survival rate were 20% ,60% and 65% in group A, B and C, respectively. In all groupo,the levels of TNF-α,IL-1 and IL-10 increased significantly in development of the two-hit attack. In group B and C ,at time points T4 and T5 ,the levels of TNF-α and IL-1 were much lower than those in group A,meanwhile at time points T3 ,T4 and T5 the IL-10 levels were significantly higher than those in group A. But, the TNF-α ,IL-1 and IL-10 levels had not significant differences in group B and C at all time points. Conclusions In the rats with two-hit model of combined acute severe hemorrhagic shock and endotoxin infusion,the drag reducing polymer could enhance the survival rate,and one of the possible mechanisms is by modulating the serum cytokines＇ concentration.