高渗盐液复苏创伤失血性休克大鼠对细胞间黏附因子-1和肾脏的影响

目的建立创伤失血性休克动物模型,观察高渗盐液及乳酸林格液复苏后对细胞间黏附因子-1(ICAM-1)及肾脏的影响。方法66只雄性SD大鼠,随机分为3组,假休克组(sham组,n=6),乳酸林格液复苏组(LRS组,n=30),高渗盐液复苏组(HSH组,n=30)。复制创伤失血性休克动物模型后,经静脉输入高渗盐液或乳酸林格液,然后腹主动脉取血,酶联免疫吸附法测ICAM-1。取一侧肾脏HE染色,光镜观察组织形态改变。结果HSH组与LRS组中ICAM-1浓度于复苏后2h开始增加,分别为(371±16)ng/ml、(382±22)ng/ml,至12h最高分别为(486±20)ng/ml、(620±31)ng/ml,与sham组(349±10)ng/ml比较,各时间点差异均有显著意义(P<0.05);HSH组各时间点ICAM-1浓度明显低于LRS组(P<0.01)。肾脏HE染色光镜见LRS组肾小管腔内可见丝网状絮状物,肾间质少量瘀血,肾小管上皮细胞空泡变性,随时间的延长,病理改变加重,HSH组病变轻于LRS组。结论高渗盐液可降低复苏后血中ICAM-1的浓度,使复苏后肾脏的缺血—再灌注损伤减轻。

Effect of hypertonic saline on intercellular adhesion molecule- 1 and the kidney for resuscitation of traumatic hemorrhagic shock in rats

ObjectiveTo build traumatic-hemorrhagic shock model in rats and to investigate the effects of hypertonic saline and hydroxyethyl(HSH) on intercellular adhesion molecule-1(ICAM-1) and the kidney for the resuscitation traumatic hemorrhagic shock in rats.Methods66 male Sprague-Dawley(SD) rats were randomly divided into three groups:sham-shock group(n=6),lactated Ringers resuscitation group(LRS group,n=30),and hypertonic saline resuscitationgroup(HSH group,n=30).After the traumatic-hemorrhagic shock models in rats were duplicated,the rats were resuscitated with hypertonic saline or lactated Ringers.After artery blood samples were obtained,the levels of ICAM-1 were tested by ELISA.Kidney samples at different time points were taken for histological analysis.ResultsThe levels of ICAM-1 were remarkably increased at 2 hours after resuscitation in HSH group(371±16)ng/ml and LRS group(382±22)ng/ml,with a peak at 12 hours after resuscitation which was(486±20)ng/ml and(620±31)ng/ml respectively,compared with those in the sham group(349±10)ng/ml(P<0.05).The serum levelsof ICAM-1 were decreased significantly in HSH group,as compared with those in LRS group(P<0.01).The changes of histological structures of kidney could be seen,such as sill-net shape padding in renal tubule in LRS group,and renal alveolar space extravasated a little blood,and renal tubule cells were changed into foam.With the time going on the changes turned serious.The changes in LRS group were more obvious than that in HSH group.ConclusionApplication of HSH could reduce the concentration of ICAM-1 in resuscitate traumatic-hemorrhagic shock and could improve the ischemia-reperfusion injury of kidney after resuscitation.