输注白蛋白能减轻创伤/失血性休克中的肺损伤吗？

Can albumin administration relieve lung injury in trauma/hemorrhagic shock?

作者信息

Chen Zuo-Bing, Wang Zi-Wei, Ding Chen-Yan, Yan Jian-Hua, Gao Yuan, Zhang Yun, Ni Lin-Mei, Zhou Yong-Qing

机构信息

Department of Emergency Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.

出版信息

World J Gastroenterol. 2006 Nov 14;12(42):6884-8. doi: 10.3748/wjg.v12.i42.6884.

DOI:10.3748/wjg.v12.i42.6884

PMID:17106942

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4087448/

Abstract

AIM

To study the effect of albumin administration on lung injury in trauma/hemorrhagic shock (T/HS).

METHODS

Sixty experimental animals were randomly divided into three groups: rats undergoing laparotomy without shock (T/SS); rats with T/HS and resuscitation with blood plus twice the volume of shed blood as Ringer's lactate (RL), and rats with T/HS and resuscitation with blood plus additional 3 mL of 50 g/L human albumin. Expression of polymorphonuclear neutrophil (PMN) CD11b/CD18, intercellular adhesion molecule-1 (ICAM-1) of jugular vein blood and the severity of lung injuries [determined mainly by measuring activity of lung tissue myeloperoxidase (MPO) and lung injury score (LIS)] were measured after a 3-h recovery period.

RESULTS

All three groups showed a significant difference in the expressions of CD11b/CD18, ICAM-1, and severity of lung injury. The expressions of CD11b/CD18 in T/SS group, T/HS + RL group, T/HS + albumin group were 17.76% +/- 2.11%, 31.25% +/- 3.48%, 20.36% +/- 3.21%, respectively (F = 6.25, P < 0.05). The expressions of ICAM-1 (U/mL) in T/SS group, T/HS + RL group, T/HS + albumin group were 258.76 +/- 98.23, 356.23 +/- 65.6, 301.01 +/- 63.21, respectively (F = 5.86, P < 0.05). The expressions of MPO (U/g) in T/SS group, T/HS + RL group, T/HS + albumin group were 2.53 +/- 0.11, 4.63 +/- 1.31, 4.26 +/- 1.12, respectively (F = 6.26, P < 0.05). Moreover, LIS in T/HS + RL group, T/HS + albumin group was 2.62 +/- 0.23, 1.25 +/- 0.24, respectively. The expressions of CD11b/CD18, ICAM-1 and MPO in T/HS + RL group were significantly increased compared to T/SS group (P = 0.025, P = 0.036, P = 0.028, respectively). However, administration of 3 mL of 50 g/L albumin significantly down-regulated the expressions of CD11b/CD18, ICAM-1 and lung injury index (MPO and LIS) when compared with the T/HS + RL rats (P = 0.035, P = 0.046, P = 0.038, P = 0.012, respectively).

CONCLUSION

The infusion of albumin during resuscitation period can protect lung from injury and decrease the expressions of CD11b/CD18, ICAM-1 in T/HS rats.

摘要

目的

研究白蛋白输注对创伤/失血性休克（T/HS）所致肺损伤的影响。

方法

60只实验动物随机分为三组：行剖腹术但未休克的大鼠（T/SS）；T/HS大鼠，用等量血液加两倍失血量的乳酸林格液（RL）复苏；T/HS大鼠，用等量血液加额外3 mL 50 g/L人白蛋白复苏。在3小时恢复期后，检测颈静脉血中多形核中性粒细胞（PMN）CD11b/CD18、细胞间黏附分子-1（ICAM-1）的表达以及肺损伤严重程度[主要通过测定肺组织髓过氧化物酶（MPO）活性和肺损伤评分（LIS）来确定]。

结果

三组在CD11b/CD18、ICAM-1表达及肺损伤严重程度方面均有显著差异。T/SS组、T/HS + RL组、T/HS + 白蛋白组的CD11b/CD18表达分别为17.76%±2.11%、31.25%±3.48%、20.36%±3.21%（F = 6.25，P < 0.05）。T/SS组、T/HS + RL组、T/HS + 白蛋白组的ICAM-1（U/mL）表达分别为258.76±98.23、356.23±65.6、301.01±63.21（F = 5.86，P < 0.05）。T/SS组、T/HS + RL组、T/HS + 白蛋白组的MPO（U/g）表达分别为2.53±0.11、4.63±1.31、4.26±1.12（F = 6.26，P < 0.05）。此外，T/HS + RL组、T/HS + 白蛋白组的LIS分别为2.62±0.23、1.25±0.24。与T/SS组相比，T/HS + RL组的CD11b/CD18、ICAM-1和MPO表达显著增加（分别为P = 0.025、P = 0.036、P = 0.028）。然而，与T/HS + RL大鼠相比，输注3 mL 50 g/L白蛋白可显著下调CD11b/CD18、ICAM-1表达及肺损伤指标（MPO和LIS）（分别为P = 0.035、P = 0.046、P = 0.038、P = 0.012）。