【摘要】 目的初步探讨不同剂量6%羟乙基淀粉(HES,200/0.5)输注后预防内毒素感染型大鼠急性肺损伤(ALI)的作用机制。方法健康雄性SD清洁级大鼠50只,随机分成5组(每组10只),A1-A3及B组均股静脉注射大肠杆菌脂多糖(LPS)5mg/kg,1分钟后以0.2ml/min的速度分别持续输注6%HES 3.75ml/kg、7.5ml/kg、15ml/kg及NS 7.5ml/kg;C组(对照组)给予等容量的NS。致伤后4小时观察动脉血气、肺组织匀浆丙二醛(MDA)、超氧化物歧化酶(SOD)活性,一氧化氮(NO)的变化;肺含水率,支气管肺泡灌洗液(BALF)内蛋白含量、白细胞数量及分类的变化。结果A1-A3及C组动脉氧分压(PaO2),剩余碱(BE)值明显高于B组(P<0.01);A3组动脉二氧化碳分压(PaCO2)低于A2、B组及C组。肺组织匀浆MDA、NO含量、肺含水率、BALF内蛋白含量、白细胞数量及分类A1-A3和C组均低于B组;A1-A3和C组SOD活性均高于B组;A2组与C组差异不明显。结论3.75ml/kg、7.5ml/kg1、5 ml/kg 6%HES通过一定程度的血液稀释,防止和堵塞毛细血管渗漏效应,抑制内皮细胞活化而阻断白细胞的黏附及迁移,从而减轻炎症损伤,对ALI有明显的保护作用,但7.5ml/kg HES的效应最佳。更多还原

【Abstract】 Objective To study the mechanism of different dosages hydroxyethyl starch in protecting acute lung injury（ALI） in endotoxin-induced rats.Methods Fifty male SD rats weighing 250-300g were randomly divided into 5 groups with 10 animals in each group: in group A1-A3 1 min after lipopolysaccharide（LPS 5mg/kg） 6% HES（200/0.5） 3.75ml/kg,7.5ml/kg,15ml/kg were infused IV respectively at a rate of 0.2ml/ml;group B received LPS 5mg/kg IV and 0.9% N.S 7.5ml/kg;group C served as control one by giving the same volume of N.S.The animals were anesthetized with 3% pentobarbital 30mg/kg.Right femoral vein was injected LPS.Right internal jugular vein was punctured with 5# needle for continuous intravenous infusion.Four hours later,1ml blood sample were taken from abdominal aorta to analyze PaO₂,PaCO₂ and BE value before giving out blood and executing them.Lung MDA,NO contents and activity of SOD were determined.Right upper lobe of lung were calculated lung water content.The left lobe of lung were lavaged with 0℃-4℃ 0.9% normal saline through the left main bronchus to obtain bronchoalveolar lavage fluid（BALF）.The total protein content of BALF was measured.Percent and numbers of WBC in BALF were analyzed in each group.Rusults PaO₂,BE values, lung water content were significantly lower in group B than those in any other group（P<0.01）.PaCO₂ were significantly lower in group A3 than those in group A2,B,and C.Lung MDA,NO contents and the total protein content,percent,numbers of WBC of BALF in group A1,A3,B was increased significantly,however,the activity of lung SOD in group A1,A3,B was decreased significantly.But there was no difference in that of group A2 and C（P>0.05）.Conclusion 6% HES（200/0.5） can dilute blood and jam the leak of capillary vessel.It can significantly inhibit the activation of endotheliocyte and prevent WBC from conglutinating and moving accordingly decrease the degree of acute lung injury induced by lipopolysaccharide.6% HES（200/0.5） has significantly protective effect of preventing ALI,however,the protective effect of HES 7.5ml/kg was best.更多还原