本文選題：膿毒癥休克 + 急性肺損傷��； 參考：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2014年05期

【摘要】：目的:評(píng)價(jià)多巴胺和去甲腎上腺素對(duì)膿毒癥休克兔急性肺損傷的保護(hù)作用。方法:采用盲腸結(jié)扎穿孔(CLP)聯(lián)合靜脈注入內(nèi)毒素的方法復(fù)制膿毒癥休克動(dòng)物模型,將63只新西蘭大白兔分為假手術(shù)對(duì)照組(A組,n=7)、模型組(B組,n=14)、多巴胺治療組(C組,n=14)、去甲腎上腺素治療組(D組,n=14)、多巴胺聯(lián)合去甲腎上腺素治療組(E組,n=14),各組分別于造模后3、6 h處死7只。留取血清標(biāo)本,用酶聯(lián)免疫吸附測(cè)定法(enzyme-linked immunosorbent assay,ELISA)檢測(cè)各時(shí)相點(diǎn)血清中肺泡表面活性蛋白A與肺泡表面活性蛋白D(surfactant protein A and surfactant protein D,SP-A and SP-D)的濃度值,并留取肺組織標(biāo)本做光鏡和電鏡檢查。結(jié)果:各組血清中SP-A與SP-D的濃度值在各時(shí)相點(diǎn)均高于A組(P0.05);與B組比較,C組血清中SP-A與SP-D的濃度值在3、6 h差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);D、E組血清中SP-A與SP-D的濃度值在3、6 h均顯著低于B組(P0.05)。形態(tài)學(xué)觀察發(fā)現(xiàn)D、E組肺組織損傷明顯輕于B、C組。結(jié)論:膿毒癥休克時(shí)肺組織損傷嚴(yán)重;單獨(dú)應(yīng)用去甲腎上腺素或聯(lián)合應(yīng)用去甲腎上腺素和多巴胺可以有效減輕膿毒癥休克引起的肺組織損傷,對(duì)肺組織起保護(hù)作用。
[Abstract]:Aim: to evaluate the protective effects of dopamine and norepinephrine on acute lung injury in septic shock rabbits. Methods: septic shock model was established by cecal ligation and perforation combined with intravenous injection of endotoxin. 63 New Zealand white rabbits were divided into sham operation control group (group A), model group B (group B), dopamine group C (group C), noradrenaline group (group D), and dopamine plus norepinephrine treatment group (group E). 7 rats were killed at 6 hours after the model. Serum samples were collected and the concentrations of alveolar surfactant protein A and alveolar surfactant protein D(surfactant protein A and surfactant protein SP-A and SP-D were detected by enzyme-linked immunosorbent assaysa at different time points. The specimens of lung tissue were examined by light microscope and electron microscope. Results: the concentration of SP-A and SP-D in serum of each group was higher than that of group A at each time phase, and the concentration of SP-A and SP-D in group C was not significantly different from that in group B at 3h. There was no significant difference in the concentration of SP-A and SP-D between group A and group C at 36 h. All of them were significantly lower than group B (P 0.05). Morphological observation showed that the lung tissue injury in DU E group was significantly lighter than that in BU C group. Conclusion: the lung tissue injury is serious in septic shock and norepinephrine alone or combined with norepinephrine and dopamine can effectively attenuate the lung tissue injury induced by septic shock and play a protective role in the lung tissue.
【作者單位】： 南京醫(yī)科大學(xué)附屬南京醫(yī)院急診科;
【基金】：南京市衛(wèi)生局重大項(xiàng)目(2007-3-7)
【分類(lèi)號(hào)】：R563.8

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