休克肠淋巴液引流对大鼠红细胞代谢的作用

目的 观察休克肠淋巴液引流对失血性休克大鼠红细胞三磷酸腺苷(ATP)、乳酸(LA)、2,3-二磷酸甘油酸(2,3-DPG)以及红细胞内外离子浓度的影响,揭示肠淋巴途径在休克发病学中的意义.方法 Wistar雄性大鼠均分为假休克组、休克组(复制失血性休克模型)、引流组(复制失血性休克模型,自低血压1h引流休克肠淋巴液).在低血压3h或相应时间,经腹主动脉取血,制备红细胞悬液检测红细胞ATP、LA水平；制备红细胞内液检测2,3-DPG、Na+、K+浓度；制备血浆,检测Na+、K+、Cl-、Ca浓度.结果 休克组、引流组大鼠红细胞2,3-DPG、LA含量显著高于、ATP含量显著低于假休克组,且引流组2,3-DPG、ATP含量高于休克组；休克组血浆仅K+浓度高于假休克组、引流组红细胞内液Na+浓度显著低于休克组.结论 失血性休克大鼠红细胞能量代谢障碍的表现为2,3-DPG代偿性增加、ATP减少、LA堆积,并引起血钾升高；休克肠淋巴液引流增强了2,3-DPG的代偿、提高了ATP生成、减少LA堆积.肠淋巴液在休克红细胞能量代谢障碍的发病学中发挥重要作用.

Effects of shock mesenteric lymph drainage on metabolism of RBC from rats subjected to hemorrhagic shock

【Objective】 To observe the effects of mesenteric lymph drainage on adenosine triphosphate(ATP),lactic acid(LA),2,3-diphosphoglycerate(2,3-DPG) of RBC as well as ion concentration intra-and extracellular fluid of RBC in rats subjected to hemorrhagic shock and resuscitation,and explore the significance of mesenteric lymph pathway playing in the pathogenesis of shock process.【Methods】 Wistar rats were randomly divided into sham-shock group,shock group(duplicating hemorrhagic shock model),drainage group(duplicating hemorrhagic shock model plus drainaging shock mesenteric lymph from hypotension 1 h).At 3 h of hypotension or corresponding time,blood samples were harvested from the abdominal aorta.Membrane suspension of RBC prepared from part of whole blood samples was used to measure the contents of ATP and LA,the intracellular fluid of RBC prepared from part of whole blood samples was used to determine the ion concentration of Na+,K+ and 2,3-DPG,plasma samples isolated from blood by centrifugation were used to determine the concentration of Na+,K+,Cl-and Ca.【Results】 In shock and drainage groups,the contents of 2,3-DPG and LA were increased and the contents of ATP were decreased significantly when compared with those of sham group.Furthermore,the contents of 2,3-DPG and ATP in drainage group were increased significantly compared with those of shock group.The concentration of K+ in plasma in shock group was significantly increased compared with that in sham group.The concentration of Na+ in intracellular fluid of RBC in drainage group was significantly decreased when compared with that of shock group.【Conclusion】 The results indicate that erythrocyte energy metabolic dysfunction of hemorrhagic shock rats is charactered by 2,3-DPG enhancement,ATP depletion,LA accumulation and hyperkalemia,the drainage of shock mesenteric lymph increases the compensation of 2,3-DPG,elevates the contents of ATP,blunters the accumulation of LA.In this viewpoint,mesenteric lymph plays an important role in pathogenesis of erythrocyte energy metabolic dysfunction of shock.