不同剂量液体复苏对脓毒性休克大鼠炎症因子调控及安全性评价.docx

不同剂量液体复苏对脓毒性休克大鼠炎症因子调控及安全性评价 陈星海 张京晓 李杏良 刘德新【摘要】目的：评价不同剂量的液体复苏对脓毒性休克大鼠炎症因子水平的影响及安全性。方法：采用改良盲肠结扎穿孔法制备脓毒性休克大鼠模型，随机分为小剂量、中剂量、大剂量液体复苏组，达到休克后分别给予30ml/kg，45ml/kg，60ml/kg液体冲击疗法。记录液体复苏开始、液体复苏3小时、液体复苏6小时血清TNF-α，IL-6和 IL-10水平。液体复苏6小时后处死大鼠，观察大鼠肺、肝、肾、心脏的病理改变。结果：经过液体复苏3小时、6小时后，脓毒性休克大鼠的促炎因子TNF-α、IL-6水平较液体复苏开始时下降，抗炎因子IL-10水平升高，P0.05。比较小、中、大剂量液体复苏三组之间大鼠血清TNF-α、IL-6及IL-10水平，组间差异无显著性，P0.05。病理改变提示小、中、大剂量液体复苏后6小时，脓毒性休克大鼠的肺、肝、肾、心脏病理改变基本无明显差异，但在大剂量液体复苏组发现肝周细胞肿胀较其他两组明显。结论：脓毒性休克液体复苏后能明显降低体内促炎因子水平，提高抗炎因子水平，但采用不同补液剂量液体复苏对炎症因子水平影响不大。大剂量液体复苏可造成肝细胞肿胀，采用中小剂量液体复苏更为安全。【关键词】 液体冲击治疗；液体复苏；脓毒性休克；炎症因子The effect of Different dose of fluid resuscitation on inflammatory factors in septic shock rats Chen Xinghai，Zhang Jingxiao, Liu Dexin , Li Xingliang. Emergency department，The second hospital of jilin university ,Changchun130041,ChinaCorresponding author: Liu Dexin, Email: ldxicu@[abstract] objective: To evaluate the effect of Different dose of fluid resuscitation on inflammatory factors in septic shock rats. Methods: We use Healthy adult clean level male SD rats with improved cecum ligation and perforation methord to make the model of sepsis shock. then select 49 achieved septic shock rats, randomly divided into 7 groups (each group of 7). Control group With no intervention, while in the ther groups the rats were given 30 ml/kg, 45 ml/kg, 60 ml/kg liquid resuscition therapy in 3 h or 6 h until acchieve stable blood pressure . we detect the level of TNF alpha, IL - 6 and IL - 10 levels at 6h and 12h, then put the rats to death at 12h to observation the lung, liver, kidney, heart. Results: the control group compared with liquid resusciation groups, IL - 6, TNF alpha cytokine levels significantly higher (P ﹤ 0.05). the level of IL – 6 and TNF alpha cytokines decreased most in 45 ml/kg liquid resusciation group more obviously among the 3 h liquid resusciation groups. the level of IL – 6 and TNF alpha cytokines decreased most in 60 ml/kg liquid resusciation group more obviously among the 6 h liquid resusciat