不同剂量羟乙基淀粉130/0.4对失血性休克大鼠肾损伤的影响

目的评价不同剂量羟乙基淀粉(HES)130/0.4复苏对失血性休克大鼠肾损伤的影响。方法健康成年雄性SD大鼠50只,随机分为5组,每组10只。对照组(C组)仅麻醉不放血;另外4组通过放血或回输失血使平均动脉压(MAP)降至40 mm Hg,并维持90 min,然后分为:失血性休克组(HS组)、33 ml/kg复苏组(HA组)、50 ml/kg复苏组(HB组)和70 ml/kg复苏组(HC组)。于休克前(T_0)、复苏前(T_1)及复苏3 h(T_2)分别记录MAP,并采集动脉血进行血气分析。于T_2时处死动物,取左肾上极组织制备匀浆测定超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量,另取右肾下极组织观察肾组织形态学及超微结构的变化,进行肾组织Paller标准评分及空泡变性程度评分。结果不同剂量HES 130/0.4复苏后,各组血流动力学及血气指标改善较好,HA组优于HB组及HC组(P<0.05)。肾组织MDA含量、Paller标准评分和空泡变性程度评分的比较:HS组>HC组>HB组>HA组和C组(P<0.05);肾组织SOD活性的比较:HS组

The effect of different doses of hydroxyethyl starch 130/0.4 on the kidney injury in hemorrhagic shock rats

Objective To evaluate the effect of different （loses of hydroxyethyl starch （ HES ） 130/0.4 on the kidney injury in hemorrhagic shock rats. Methods Fifty adult male SD rats were randomly divided into five groups （ n = 10）. The control group （C group） was anesthetized without bloodletting, and other 4 groups were induced to hemorrhahagic shock with bloodletting to decrease mean arterial pressure （MAP） at 40 mm Hg. The pressure was maintained for 90 minutes by withdrawing or reinfusing blood, and then without recovery （ HS group） ,with 33 ml/ kg 6% hydroxyethyl starch 130/0.4 solution （HA group） ,with 50 ml/kg 6% hydroxyethyl starch 130/0.4 solution （HB group）,and with 70 ml/kg 6% hydroxyethyl starch 130/0.4 solution （HC group）. The MAP and blood gas analysis were recorded at the time point of before shock （ T0 ） , before recovery （ T1 ） and 3h after recovery （ T2 ）. Execute the rat at 3h after recovery and record the kidney malondialehehyche （MDA） levels and superoxide dismutase （SOD） activity. To observe the histomorphology and uhramicrostructure of kidney, marking it based on the standard of Paller and the degree of vacuolar degeneration. Results With different doses of hydroxyethyl starch recovery, the MAP and blood gas analysis indexes were improved compared with the hemorrhagic shock group,furthermore ,the HA group was better than HB and HC group （ P 〈 0.05 ）. The comparison of the kidney MDA levels and the scores based on the standerd of Pallet and the degree of vacuolar degeneration displayed that the HS group 〉 HC group 〉 HB group 〉 HA and C group （ P 〈 0.05 ）. The comparison of the kidney SOD activity displayed that the HS group 〈 HC group 〈 HB group 〈 HA and C group （ P 〈 0.05 ）. Conclusion The hydroxyethyl starch 130/0.4 could attenuate hemorrhagic shock and resuscitation reduced kidney injury.