乌司他丁对创伤失血性休克兔血浆磷脂酶A2水解产物及细胞因子的影响

摘要

Objective:To evaluate the effects of Ulinastatin, a protease inhibitor, on TXA2/PGI2 and cytokines in traumatic hemorrhagic shock.Methods:Thirty rabbits were randomly divided into three groups: control group, traumatic hemorrhagic shock group and ulinastatin-treated group.. Blood was sampled at four time points: pre-shock, post-shock, as well as 2h and 4h after blood volume compensation. Plasma levels of TNF-a, IL-8 and TXA2/PGI2 were measured.Results:In control group, the plasma concentrations of TNF-α、 IL-8 and TXA2/PGI2 showed elevated changes in the duration of experiment, but without statistic significance. At the following three observed points, plasma levels of TNF-a, IL-8 and TXA2/PGI2 in traumatic hemorrhagic shock group were significantly higher than that in control group (P＜0.05),while plasma levels of TNF-α, IL-8 and TXA2/PGI2 in ulinastatin-treated group were significantly lower than that in traumatic shock group (P＜0.05).Conclusions:Ulinastatin possess beneficial effects in treatment of traumatic hemorrhagic shock, which maybe related to the reduction of the release of TNF-a, IL-8 and TXA2.%目的:评价蛋白酶抑制剂乌司他丁对创伤性休克的治疗效果,并观察乌司他丁对血浆磷脂酶A2水解产物及细胞因子的影响.方法:30只新西兰白兔随机分为三组,对照组、创伤性休克组和创伤性休克乌司他丁治疗组,观察休克前后TXA2和PGI2,、TNF-a、IL-8的动态变化及乌司他丁对它们的影响.结果:对照组TNF-a、IL-8的血浆浓度和TXA2/PGI2的比值在整个实验期呈现增高趋势,但没有统计学意义.创伤性休克组和创伤性休克乌司他丁治疗组休克后TXA2、TNF-α、IL-8的血浆浓度分别在不同的时点较休克前有显著增高,其中乌司他丁治疗组的TXA2、TNF-α、IL-8血浆浓度均明显低于休克组.光镜及电镜下观察肺组织,乌司他丁治疗组较休克组的病理损害亦显著减轻.结论:在创伤性休克的发展过程中血浆磷脂酶A2水解产物及细胞因子起着重要作用,应用蛋白酶抑制剂乌司他丁有助于休克的改善及重要脏器的保护.