多巴胺和去甲肾上腺素对脓毒症休克兔急性肺损伤的保护作用

目的:评价多巴胺和去甲肾上腺素对脓毒症休克兔急性肺损伤的保护作用?方法:采用盲肠结扎穿孔(CLP)联合静脉注入内毒素的方法复制脓毒症休克动物模型,将63只新西兰大白兔分为假手术对照组(A组,n = 7)?模型组(B组,n = 14)?多巴胺治疗组(C组,n = 14)?去甲肾上腺素治疗组(D组,n = 14)?多巴胺联合去甲肾上腺素治疗组(E组,n = 14),各组分别于造模后3?6 h处死7只?留取血清标本,用酶联免疫吸附测定法 (enzyme-linked immunosorbent assay,ELISA)检测各时相点血清中肺泡表面活性蛋白A与肺泡表面活性蛋白D(surfactant protein A and surfactant protein D,SP-A and SP-D)的浓度值,并留取肺组织标本做光镜和电镜检查?结果:各组血清中SP-A与SP-D的浓度值在各时相点均高于A组(P < 0.05);与B组比较,C组血清中SP-A与SP-D的浓度值在3?6 h差异均无统计学意义(P > 0.05);D?E组血清中SP-A与SP-D的浓度值在3?6 h均显著低于B组(P < 0.05)?形态学观察发现D?E组肺组织损伤明显轻于B?C组?结论:脓毒症休克时肺组织损伤严重;单独应用去甲肾上腺素或联合应用去甲肾上腺素和多巴胺可以有效减轻脓毒症休克引起的肺组织损伤,对肺组织起保护作用?

Protective effects of dopamine and norepinephrine on the acute lung injury in a rabbit model of septic shock

Objective:To evaluate the protective effects of dopamine and norepinephrine on the actue lung injury(ALI) in a rabbit model of septic shock. Methods:A cecal ligation and puncture procedure combined with intravenous injection of lipopolysaccharides was used to make a septic shock model. Sixty three rabbits were randomly divided into 5 groups:sham operation group(group A,n =7),septic shock group(group B,n = 14),dopamine treatment group(group C,n = 14),norepinephrine treatment group (group D,n = 14),and dopamine combined with norepinephrine treatment group(group E,n = 14). Seven rabbits from each group were sacrificed 3 and 6 hours after septic shock,the concentration values of surfactant protein A and surfactant protein D(SP-A and SP-D)in plasma were tested by ELISA method and the morphological changes of lung tissue were performed at 3 and 6 h. Results:The concentrations of SP-A and SP-D in each group were significantly increased than those in group A(P < 0.05). No significant differences in the concentration values of SP-A and SP-D in plasma were found between group B and C at 3 and 6 h(P > 0.05);in group D and E,the concentration values of SP-A and SP-D in plasma were significantly lower than those in group B at 3 h and 6 h(P < 0.05). The morphological changes of lung tissue were lessened in group D and E than those in group B and C. Conclusion:The lung tissue was injured severely in septic shock model. Norepinephrine or norepinephrine combined with dopamine can relieve the lesion of lung tissue and play a protective role.