创伤性休克大鼠血浆肾上腺髓质素和一氧化氮变化与组织器官保护的相关性

背景:创伤性休克后,有大量炎性因子、一氧化氮合成、释放,在休克向不可逆的转化过程中起着重要作用。目的:探讨创伤性休克时大鼠血浆肾上腺髓质素(AM)和一氧化氮的变化特点及相关性。设计:随机对照实验研究。地点和材料:实验在第一军医大学珠江医院完成。健康SD大鼠40只,雌雄不拘,质量280～300g。由第一军医大学实验动物中心提供。干预:将40只SD大鼠分为对照组(10只)、休克未复苏组(10只)、休克复苏组(10只)和氨基胍(Aminoguanidine,AG)组(10只)。对照组10只麻醉后插管;30只SD大鼠制作创伤性休克动物模型,双侧股骨干砸伤后并经股动脉放血至MAP35～45mmHg。休克复苏组血压维持30min,然后回输失血和等量的林格氏液。氨基胍组在复苏时静脉注射AG60mg/kg。观察休克前后血浆AM和一氧化氮浓度的动态变化。主要观察指标:4组大鼠在创伤性休克时AM和一氧化氮的变化及相关性。结果:大鼠创伤性休克后,未复苏组和复苏0.5h时AM分别为(86.89±2.23)和(43.88±2.74)ng/L达到高峰;一氧化氮浓度分别为(47.88±2.29)和(86.56±2.15)μmol/L,均高于对照组。氨基胍组两指标变化不明显,AM的变化与一氧化氮的变化呈正相关。结论:提示AM与一氧化氮在创伤性休克发生发展中起重要的调节作用,且AM可能是通过一氧化氮介导而发生作用

Correlation of the changes of blood adrenomedullin and nitric oxide with the protection of organ in rats with traumatic shock

BACKGROUND: Many inflammatory factors and nitric oxide(NO) are synthesized and released in traumatic shock, and play important roles in the process of shock.OBJECTIVE: To investigate the changes and correlation of adrenomedullin (AM) and nitric oxide(NO) in rats with traumatic shock.DESIGN: Randomized and controlled experimental study was adopted.SETTING and MATERIALS: The experiment was completed in Zhujiang Hospital of the First Military Medical University. Forty healthy SD rats, of either gender, weighing 280 - 300 g, were provided by the Experiment Animal Center of the First Military Medical University.INTERVENTION: Fourty Sprague-Dawley(SD) rats were randomly divided into control group(n= 10), traumatic shock without resuscitation group(n=10), traumatic shock on resuscitation group( n = 10) and aminpguandine(AG) group(n=10) . Ten rats as controls received cannulation after anesthesia. Thirty SD rats were made animal models of traumatic shock. Shafts of femurs of both sides were crashed and bled to mean arterial pressure(MAP) of 35 -45 mm Hg via femoral artery. Hypotention of rats in traumatic shock on resuscitation group were maintained 30 minutes,and then the lost blood was returned with an infusion with Ringer' s solution of the equal quantity. Rats of aminpguandine group were injected with aminpguandine 60 mg/kg. Then the changes of Plasma levels of AM and NO were observed.MAIN OUTCOME MEASURES: Changes and correlation of AM and NO after traumatic shock among the rats of the four groups.RESULTS: After the traumatic shock, the peak plasma level of AM at the 0.5 hour time point of the group without resuscitation and the group on resuscitation were (86. 89 ±2.23) and (143.88 ±2.74) ng/L respectively and the levels of NO were (47.88 + 2.29) and (86.56±2.15)μmol/L respectively, which were all higher than those of the control group. Changes were not significant in plasma level of AM and NO in aminpguandine group. The changes of concentration of AM were positively correlated with those of NO.CONCLUSION: AM and NO plays an important role in the pathological process of traumatic shock. The role played by AM in the process is probably through the mediation of NO.