聚乙二醇用于感染性休克早期大鼠液体复苏的实验研究

摘要

Objective To determine the effects of low dose drag-reducing polymer polyethylene glycol( PEG) in fluid rnresuscitation of infectious shock nonage. Methods Lipopolysaccharide was injected to 20 Wistar rats via intravenous to estabrnlish septic shock model. The mieroeirculation state of spinotrapezius muscle was observed and recorded under microscope. The rnrats were randomly divided into two groups. The observation group was given sodium chloride containing polyethylene glycol and rncontrol group was given sodium chloride only. The microvessel diameter,unit intravascular leukocyte counts per minute,leukorncyte rolling velocity and the number of adherent leukocytes were recorded before and after nmdeling and after resuscitation;rnmean arterial blood pressure and lactate concentration were monitored dunng the procedure. The live time of rats after resuscirntation also was recorded. Results Compared with before modeling, the microcirculation blood flow velocity reduced and white rnblood cell count of rats increased group( P ＜ 0. 01 ) ,rolling slowly( P＜ 0. 01 ) , adherence increased ( P ＜ 0. 01 ) , blood pressure rndecreased ( P ＜ 0. 01 ) , blood lactate levels were significantly increased ( P ＜0. 01 ) in observation. After fluid resuscitation,rncompared with control group.the blood flow velocity of microcirculation increased, urut intravascular leukocyte counts per mirnnute decreased( P ＜ 0. 05 ) , Ieukocyte rolling velocity faster ( P ＜ 0. 05 ) , the number of adherent leukocytes decreased ( P ＜rn0. 05 ) , the blood pressure increased ( P ＜0. 01 ) , the concentration of lactate decreased ( P ＜ 0. 01 ) , and the survival time prornlonged(P ＜0. 01 )in observation group Conclusion PEG can improve the microcirculation in septic shock situation of rats,rnstable the blood pressure.lower lactate concentration and prolonging the sunrival time of rats.%目的 探讨小剂量减阻剂聚乙二醇(PEG)在感染性休克早期大鼠液体复苏中的作用.方法 2 0只大鼠静脉注射内毒素(LPS)建立感染性休克模型,在显微镜下观察脊斜肌微循环并录像.造模成功后随机分为2组,观察组给予苎方氯化钠+PEG液复苏,对照组给予相同剂量的复方氯化钠+生理盐水复苏,记录造模前、造模成功和复苏后大鼠微血管管径、单位血管内每分钟通过白细胞数量、白细胞滚动速度、贴壁白细胞数量,同时监测平均动脉压变化及血乳酸浓度,记录复苏结束后大鼠生存时间.结果 与造模前相比,给予LPS后大鼠局部微循环血液流速减缓,白细胞数量增多(P<0.01),滚动缓慢(P<0.01),贴壁数量增加(P<0.01),血压明显下降(P<0.01),血乳酸水平明显上升(P<0.01).液体复苏后,与对照组相比,观察组微循环血液流速明显加快,单位血管内每分钟通过的白细胞数量较少(P<0.05),白细胞滚动速度增快(P<0.05),贴壁白细胞数量减少(P<0.05),血压明显高于对照组(P<0.01),血乳酸值则明显降低(P<0.01),生存时间明显延长(P<0.01).结论 PEG能够改善感染性休克大鼠早期液体复苏时的微循环,并能更好地维持血压,降低血乳酸浓度,延长生存时间.