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[低血压液体复苏对未控制失血性休克孕兔肺缺血再灌注损伤的保护作用]

[Protective effect of hypotensive fluid resuscitation against lung ischemia-reperfusion injury in pregnant rabbits with uncontrolled hemorrhagic shock].

作者信息

Qin Wei, Yu Yan-Hong, Sheng Chao

机构信息

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2008 Jun;28(6):1042-4.

Abstract

OBJECTIVE

To evaluate the effects of different fluid resuscitation strategies on superoxide dismutase (SOD), malondialdehyde (MDA) and myeloperoxidase (MPO) activities in the lung tissue in pregnant rabbits with uncontrolled hemorrhagic shock.

METHODS

Thirty pregnant New Zealand rabbits were randomized into 5 equal groups, namely the sham shock.(SS) group, shock group without interventions (SH group), and hemorrhagic shock groups with conventional normal saline (NS) resuscitation, NS hypotensive resuscitation, and hypertonic hyperosmotic hypotensive resuscitation (NS, NH, HHH groups, respectively) 30 min after the shock. At the end of the experiment, the rabbits were sacrificed, and the lungs were taken for detection of MDA, MPO and SOD levels.

RESULTS

Ischemia-reperfusion injury of the lungs in uncontrolled hemorrhagic shock resulted in decreased SOD and increased MDA and MPO contents. The MDA and MPO contents in HHH group were significantly lower than those in NH group, and both the groups, MDA and MPO contents were significantly lower than those of NS group (P<0.05). SOD activity was significantly higher in HHH group than in NH group (P<0.05).

CONCLUSION

In pregnant rabbits with uncontrolled hemorrhagic shock, hypotensive resuscitation more effectively ameliorates ischemia-reperfusion injuries in the lungs than aggressive fluid resuscitation, and hyperosmotic crystalloid and hyperonoctic colloid resuscitation provide significant protective effects against such injuries.

摘要

目的

评估不同液体复苏策略对未控制出血性休克孕兔肺组织中超氧化物歧化酶(SOD)、丙二醛(MDA)和髓过氧化物酶(MPO)活性的影响。

方法

将30只孕新西兰兔随机分为5组,每组数量相等,即假休克组(SS组)、未干预休克组(SH组),以及休克后30分钟分别采用常规生理盐水(NS)复苏、NS低血压复苏和高渗高张性低血压复苏的出血性休克组(分别为NS组、NH组、HHH组)。实验结束时,处死兔子,取肺组织检测MDA、MPO和SOD水平。

结果

未控制出血性休克导致肺组织缺血再灌注损伤,使SOD降低,MDA和MPO含量升高。HHH组的MDA和MPO含量显著低于NH组,且两组的MDA和MPO含量均显著低于NS组(P<0.05)。HHH组的SOD活性显著高于NH组(P<0.05)。

结论

在未控制出血性休克的孕兔中,低血压复苏比积极液体复苏更有效地改善肺组织缺血再灌注损伤,高渗晶体液和高渗胶体液复苏对这类损伤具有显著的保护作用。

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