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乳酸林格氏液复苏会导致失血性休克后中性粒细胞活化。

Lactated Ringer's solution resuscitation causes neutrophil activation after hemorrhagic shock.

作者信息

Rhee P, Burris D, Kaufmann C, Pikoulis M, Austin B, Ling G, Harviel D, Waxman K

机构信息

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.

出版信息

J Trauma. 1998 Feb;44(2):313-9. doi: 10.1097/00005373-199802000-00014.

Abstract

PURPOSE

To determine the degree of neutrophil activation caused by hemorrhagic shock and resuscitation.

METHODS

Awake swine underwent 15-minute 40% blood volume hemorrhage, and a 1-hour shock period, followed by resuscitation with: group I, lactated Ringer's solution (LR); group II, shed blood; and group III, 7.5% hypertonic saline (HTS). Group IV underwent sham hemorrhage and LR infusion. Neutrophil activation was measured in whole blood using flow cytometry to detect intracellular superoxide burst activity.

RESULTS

Neutrophil activation increased significantly immediately after hemorrhage, but it was greatest after resuscitation with LR (group I, 273 vs. 102%; p < 0.05). Animals that received shed blood (group II) and HTS (group III) had neutrophil activity return to baseline state after resuscitation. Group IV animals had an increase in neutrophil activation (259 vs. 129%; p < 0.05).

CONCLUSION

Neutrophil activation occurring after LR resuscitation and LR infusion without hemorrhage, but not after resuscitation with shed blood or HTS, suggests that the neutrophil activation may be caused by LR and not by reperfusion.

摘要

目的

确定失血性休克及复苏所致中性粒细胞激活的程度。

方法

清醒猪经历15分钟40%血容量出血及1小时休克期,随后分别用以下方法复苏:I组,乳酸林格液(LR);II组,自体血;III组,7.5%高渗盐水(HTS)。IV组进行假出血及LR输注。采用流式细胞术检测全血中中性粒细胞激活情况,以检测细胞内超氧化物爆发活性。

结果

出血后中性粒细胞激活立即显著增加,但用LR复苏后激活程度最大(I组,273%对102%;p<0.05)。接受自体血(II组)和HTS(III组)的动物复苏后中性粒细胞活性恢复至基线状态。IV组动物中性粒细胞激活增加(259%对129%;p<0.05)。

结论

LR复苏及未出血时输注LR后出现中性粒细胞激活,而自体血或HTS复苏后未出现,提示中性粒细胞激活可能由LR引起而非再灌注所致。

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