摘要
目的观察不同程度急性等容性血液稀释(ANH)对家兔肺及全身氧代谢的影响。方法将24只家兔随机分为4组,每组6只,其中正常对照组(Ⅰ组)不进行血液稀释,其余3组血液稀释的目标:红细胞比容(Hct)分别为24%(Ⅱ组)、18%(Ⅲ组)、12%(Ⅳ组),分别于 ANH 前(T_0),ANH 模型建立后2h(T_1)、4h(T_2)、8 h(T_3)检测家兔血中丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性及氧摄取率(ERO_2)、呼吸力学指标,术毕测定肺组织湿/干比值(W/D)及病理改变。结果Ⅱ组各时点ERO_2、MDA 含量、SOD 活性及呼吸力学改变与Ⅰ组相比差异无显著性(P>0.05);Ⅲ组 T_3时点的 ERO_2、MDA 升高,SOD 下降及呼吸力学改变与 T_0比较差异有显著性(P<0.05),并与Ⅰ组对应时点比较有显著差别(P<0.05);Ⅳ组在 T_1时点 ERO_2、MDA 升高,SOD 下降及呼吸力学改变较 T_0差异有显著性(P<0.05),且 T_2、T_3呈增高趋势,同时3个时点与Ⅰ组对应时点比较差异有显著性(P<0.05)。结论血液稀释目标 Hct 为24%时,家兔未出现肺损伤表现;目标 Hct 为18%时,在血液稀释后8 h 后出现急性肺损伤,出现呼吸力学及病理学改变;血液稀释至 Hct 为12%时肺损伤加重。Hct 在18%～24%是家兔肺和全身氧供安全的血液稀释范围。
Objective To observe the effect of different degree acute normovolemic hemodilution （ANH） on lung and systemic oxygen metabolism in rabbits. Methods 24 healthy rabbits were randomly divided into 4 equal groups with 6 animals in each group： control group Ⅰ was without hemodilution; group Ⅱ which Her was 24% ; group Ⅲ which Her was 18% ;group Ⅳ which Her was 12%. Blood sample were taken before hemodilution（T0）, and at 2 hours（T1） ,4 hours （T2） and 8 hours （T3）after hemodilution for determination of plasma level of MDA, SOD, ERO2 and respiratory mechanics. At the end of the experiment, the lungs were obtained for microscopic examination and determination of wet/dry lung weight ratio （W/D）. Results There was no significant difference in ERO2, MDA content, SOD activity and respiratory mechanics between group Ⅰ and Ⅱ ：ERO2,MDA content, SOD activity raised up and changes of respiratory mechanics appeared at 8 hours after hemodilution in groups Ⅲ（ P 〈 0. 05 ）. In group Ⅳ, ERO2, MDA content SOD activity and changes of breathing mechanics stepped up from 2 hours to 8 hours after hemodilution and were different to that points of group Ⅰ （ P 〈 0. 05 ）. Conclusion Lung injury was not observed in rabbits when target Hct was 24% ;lungs injury appeared with the changes of respiratory mechanics and pathology in rabbits of group Ⅲ which Hct was 18% ;lungs injury aggravated in rabbits of group Ⅳ which Her was 12%. ANH in the range of Her 18% -20% is safe in terms of systemic and lung O2 supply.
出处
《临床急诊杂志》
CAS
2008年第3期135-139,共5页
Journal of Clinical Emergency
关键词
急性等容性血液稀释
家兔
氧代谢
Acute normovolemic hemodilution
Rabbit
Oxygen metabolism
