高渗氯化钠羟乙基淀粉40注射液对非控制出血性休克大鼠凝血功能及脂质过氧化的影响

目的观察高渗氯化钠羟乙基淀粉40注射液(HHS40)对非控制出血性休克(UHS)大鼠凝血功能及脂质过氧化的影响。方法制备创伤非控制出血性休克模型。30只SD大鼠随机分为3组:正常对照组(NC组)、生理盐水复苏组(NS组)、HHS40组。NS组和HHS40组在大鼠的平均动脉压(MAP)降至40mm Hg时,分别给予NS和HHS40输注,使MAP维持在50mm Hg。复苏1h后,两组均给予手术止血、回输血液及给予足量的液体输注,保持MAP在90mm Hg。分别在不同时点检测大鼠的血细胞比容(Hct)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性。结果 NS组和HHS40组的Hct在T2～T4时明显低于T1时(P<0.05),HHS40组大鼠在T3、T4时Hct明显高于NS组(P<0.05)。NS组和HHS40组在T2～T4时PT、APTT明显长于T1时(P<0.05),FIB明显低于T1时(P<0.05);HHS40组在T2～T4时PT、APTT均短于NS组(P<0.05),两组之间FIB在各时间点比较差异无统计学意义(P>0.05)。NS组和HHS40组在T2～T4时,与T1时比较,MDA含量显著增高(P<0.05),SOD活性明显下降(P<0.05);与NS组大鼠相比,HHS组在T2～T4时的MDA含量明显减少(P<0.05),SOD活性显著升高(P<0.05)。结论 HHS40能防止未控制出血性休克大鼠血液过度稀释,降低氧自由基的产生,虽对凝血功能有影响,但尚未超过机体的代偿范围,具有保护作用。

Influence of hypertonic sodium chloride hydroxyethyl starch 40 on blood coagulation and lipid peroxidiation for uncontrolled hemorrhagic shock in rats

Objective To investigate the influence of hypertonic sodium chloride hydroxyethyl starch 40(HHS40)on blood coagulation and lipid peroxidiation for uncontrolled hemorrhagic shock in rat.Methods Rat models of uncontrolled hemorrhagic shock were established using the modified Capone method.SD rats(n=30) were randomly divided into 3 groups,normal control group(group NC),normal saline group(group NS) and HHS40 group.The animals were inflicted with a sharp resection of 15% of the tail to initiate the hemorrhage.When the blood pressure(MAP) was decreased to 40 mm Hg,the animals received the corresponding infusion respectively for 1 h when the MAP was increased to 50 mm Hg.The blood samples were collected at various time points to measure Hct,PT,APTT,FIB,content of malondialdehyde(MDA) and the activity of superoxide dismutase(SOD).Results Hct was decreased obviously at T2―T4 than at T1 in HHS40 group and group NS(P<0.05).HHS40 could significantly enhanced Hct of uncontrolled hemorrhagic shock rats at T2―T4 as compared with those in group NS(P<0.05),meanwhile it also obviously decreased plasma MDA of the shock rats(P<0.05).Pt and APTT were increased evidently at T2―T4 than at T1 in HHS40 group and group NS(P<0.05).PT and APTT were decreased obviously in HHS40 group than those in group NS at T2―T4(P<0.05).But FIB had no obvious difference between two groups(P>0.05).SOD was decreased obviously and MDA was increased evidently at T2―T4 than at T1 in HHS40 group and group NS(P<0.05).MDA was lower obviously and SOD was higher evidently in HHS40 group than those in group NS at T2―T4.Conclusion HHS40 can decrease hemodilution and oxygen free radicals.There is effect on blood coagulation,but exceed compensatory airframe range not yet.Therefore,it may be beneficial for the treatment of uncontrolled hemorrhagic shock.