丙酮酸腹膜透析液对大鼠失血性休克静脉液体复苏后腹腔脏器的保护作用

目的：研究丙酮酸腹腔透析液对大鼠失血性休克静脉液体复苏后腹腔脏器的保护作用。方法：雄性SD大鼠40只，随机分为4组（n=10）。大鼠按全身血容量的45％经股动脉放血制作失血性休克模型。单纯静脉复苏组（VR组）于休克1h后回输失血及2倍失血量的乳酸钠林格液行静脉复苏，其余3组在上述静脉复苏基础上，分别腹腔注射生理盐水（DPR组）、乳酸钠透析液（L组）、丙酮酸钠透析液（P组）20ml行腹腔复苏，时间30min。分别于休克前（O时）及休克后60（静脉复苏前）、180（腹腔复苏后1h）、360rain（腹腔复苏后4h）用PICCO心肺容量监测仪监测大鼠平均动脉压（MAP）；激光多普勒血流仪测定休克后180min和360min肝、肾和小肠黏膜血流量；生化法测定休克前及休克后180、360min血丙氨酸转氨酶（ALT）、二胺氧化酶（DAO）活性和肌酐（cr）水平；干／湿比重法测定休克后180、360min肝、肾、肠各组织含水率。结果：失血性休克后各组MAP骤降至（35±5）mmHg;休克后60min时，各组大鼠MAP无明显差异（P〉0．05）。腹腔复苏后，与VR组比较，L和P组均能显著提高失血性休克大鼠MAP（P〈0．05），降低血ALT、Cr和DAO水平，减轻肝、肾、肠组织含水率，提高腹腔脏器血流量（P〈0．05或P〈0．01），在失血后360min时，P组的上述变化较其余复苏组更为显著。结论：丙酮酸腹腔透析液对大鼠失血性休克静脉液体复苏后腹腔脏器具有保护作用。

Protective effects of intraperitoneal administration of pyruvate in peritoneal dialysis fluid on abdominal organ function in rats subjected to fluid resuscitation following hemorrhagic shock

Objective：To investigate the protective effects of intraperitoneal administration of pyruvate in peritoneal dialysis fluid on abdominal organ function in rats subjected to fluid resuscitation following hemorrhagic shock （HS）. Methods：Forty Sprague-Dawley （SD） rats were randomly divided into 4 groups： intravenous resuscitation group （group VR）, intraperitoneal normal saline group （group DPR）, intraperitoneal sodium lactate dialysis fluid group （group L） , and intraperitoneal pyruvic acid sodium dialysis fluid group （group P） . 450//00 of whole body blood was withdrawn via femoral artery in 4 groups of rat. In group VR, rats were resuscitated with the shed blood and sodium lactate fluid of 2 times the volume of blood loss 1 hour later. In groups DPR,L and P, after re- suscitation with the shed blood and sodium lactate fluid, the rats received intraperitoneal administration of 20 ml normal saline, 20 ml sodium lactate dialysis fluid or 20 ml pyruvic acid sodium dialysis fluid, respectively, for a duration of 30 minutes. The right common carotid artery was cannulated to monitor mean arterial pressure （MAP） with Picco cardiac function monitor. Blood flow volume of intra-abdominal organ was monitored by Laser Doppler Velocimetry at 180 minutes and 360 minutes after fluid resuscitation. 180 minutes and 360 minutes after shock, rats were sarcrifieed by femoral artery blood letting. Water content of organs was measured by proportion of dry and wet method. The activities of alanine aminotransferase （ALT）, creatinine （Cr）, and diamine oxidase （DAO） were measured by biochemistry. Results：MAP was maintained at （35±5） mmHg after hemorrhagic shock. The difference was not significant among 4 groups 60 minutes after shock （P〈0.05） . After peritoneal resuscitation,MAP in L and P groups was obviously elevated compared with group VR （P〈0.05）, while ALT, Cr and DAO were decreased, blood flow of abdominal organ was increased, and visceral tissue edema was alleviated （P〈0.05 or P〈0.01）. These changes were more significant in group P 360 minutes after hemorrhagic shock. Conelusions： The results indicate that intraperitoneal resuscitation with sodium pyruvate fluid has a protective effect on abdominal organ function in rats subjected to fluid resuscitation following hemorrhagic shock.