Angle N, Hoyt D B, Cabello-Passini R, Herdon-Remelius C, Loomis W, Junger W G
Department of Surgery, University of California San Diego, USA.
J Trauma. 1998 Jul;45(1):7-12; discussion 12-3. doi: 10.1097/00005373-199807000-00002.
Hypertonic saline (HS) reduces hemorrhage-induced lung injury by suppressing the neutrophil oxidative burst and reducing lung neutrophil influx. This study investigated whether this is caused by the effects of HS on endothelial adhesion molecule expression, the production of chemoattractants in the lung, or a direct effect of HS on neutrophil selectin expression.
BALB/c mice were made to hemorrhage to 40 mm Hg for 1 hour and resuscitated with shed blood and either 4 mL/kg 7.5% HS or two times the shed blood volume of lactated Ringer's solution (LRS). Neutrophil L selectin expression was determined by flow cytometry, total neutrophil counts were obtained by differential staining, and pulmonary endothelial P and E selectin expression was evaluated by immunohistochemistry. Chemoattractants in lung lavages were determined with a modified Boyden chamber migration assay.
Chemotactic activity of lavage fluid of HS-treated animals was not significantly different from that of LRS-treated animals, and endothelial P and E selectin expression was not altered by HS resuscitation. Neutrophils of HS-treated animals, however, expressed significantly less L selectin than those of LRS-treated mice. Concomitantly, circulating neutrophil counts of LRS-treated animals were significantly decreased compared with those of HS-treated mice.
HS had little effect on endothelial selectin expression and chemoattractant production in the lung. HS significantly decreased neutrophil L selectin expression, however. This suggests that HS resuscitation may reduce lung injury by preventing neutrophil L selectin expression and endothelial adhesion.
高渗盐水（HS）通过抑制中性粒细胞氧化爆发和减少肺内中性粒细胞流入来减轻出血性肺损伤。本研究调查了这是否是由于HS对内皮黏附分子表达、肺内趋化因子产生的影响，或者HS对中性粒细胞选择素表达的直接作用所致。
将BALB/c小鼠出血至40 mmHg持续1小时，然后用自体失血和4 mL/kg 7.5% HS或两倍自体失血量的乳酸林格液（LRS）进行复苏。通过流式细胞术测定中性粒细胞L选择素表达，通过差异染色获得中性粒细胞总数，并通过免疫组织化学评估肺内皮P选择素和E选择素表达。用改良的Boyden小室迁移试验测定肺灌洗液中的趋化因子。
HS处理动物的灌洗液趋化活性与LRS处理动物的无显著差异，HS复苏未改变内皮P选择素和E选择素表达。然而，HS处理动物的中性粒细胞L选择素表达明显低于LRS处理小鼠。同时，与HS处理小鼠相比，LRS处理动物的循环中性粒细胞计数显著降低。
HS对肺内皮选择素表达和趋化因子产生影响不大。然而，HS显著降低了中性粒细胞L选择素表达。这表明HS复苏可能通过阻止中性粒细胞L选择素表达和内皮黏附来减轻肺损伤。
