6％羟乙基淀粉130/0.4对大鼠脓毒症早期的干预作用

摘要

Objective To observe the effects of hetastarch 130/0.4 on sepsis rats in early stage. Methods A total of 72 male SD rats were randomly divided into sham operation group (n = 24) , sepsis group (re =24) and hetastarch group ( n = 24 ) . Each group was divided into three sub-groups by 6 h, 12 h, 24 h three time points, each sub-group 8 , respectively. Sepsis rats models were prepared by cecal ligation and puncture (CLP). At the three time points of various sub-routine testing, PT, APTT, PLT and TNF-a level were detected. The pathological changes in lung tissues were observed with microscope after HE staining. Results At 6 h, 12 h and 24 h, PT, APTT of sepsis group and hetastarch group were significantly longer than that of the sham operation group (P < 0.05 ). Compared with sham operation group, PLT of both groups significantly reduced(P <0.05). At 12 h and 24 h, in hetastarch group, the changes of PT, APTT and PLT levels were attenuate (all P <0.05). The TNF-a levels in plasma at different time points of sepsis group, hetastarch group were higher than those of sham operation group (all P <0. 05) , the hetastarch group at 12 h and 24 h was lower than the sepsis group (all P <0.05). Compared with sepsis group, the level of congestion and inflammatory cell infiltration was significantly ameliorated in hetastarch group in light microscopic observation of lung tissue. Conclusions Early application of hetastarch 130/0.4 on sepsis rats can reduce inflammation, improve coagulation indicators, and does not exacerbate lung injury.%目的 探讨6％羟乙基淀粉130/0.4对大鼠脓毒症早期的干预作用.方法 选择雄性SD大鼠72只,随机分为假手术组(Sham组,开腹找到盲肠但不进行结扎和穿孔)、模型组(SEP组,开腹结扎盲肠并穿孔)和羟乙基淀粉组(HES组,开腹结扎盲肠并于穿孔3h后给予6％羟乙基淀粉130/0.4),各组24只.每组又按6、12、24h三个时间点分成3个亚组,每亚组8只.分别检测3个时间点各亚组凝血酶原时间(PT)、活化部分凝血酶时间(APTT)及血小板(PLT),用ELISA法检测血浆中肿瘤坏死因子-α(TNF-α)；留取肺组织标本做HE染色,光镜下观察大鼠肺组织病理学的改变.结果 与Sham组比较,SEP组、HES组PT、APTT在各时间点明显延长(P均＜0.05),PLT明显减少(P均＜0.05),但12、24 h HES组PT、APTT升高及PLT降低程度较SEP组小(P均＜0.05)；血浆TNF-α各时间点SEP组和HES组均高于Sham组(P均＜0.05),但HES组12、24 h均低于SEP组(P均＜0.05).光镜观察肺组织发现,HES组充血及炎细胞浸润均较SEP组轻.结论 早期应用6％羟乙基淀粉130/0.4可减轻大鼠脓毒症早期炎症反应、改善凝血指标及肺功能,且不加重肺组织损伤.