摘要目的 评价复方苹果酸林格液复苏对失血性休克大鼠急性肺损伤的影响.方法SPF级健康雄性SD大鼠48只,7～9周龄,280～320 g,采用随机数字表法分为4组(n＝12):假手术组(S组)、生理盐水组(NS组)、乳酸林格液组(RL组)和复方苹果酸林格液组(RM组). NS组、RL组和RM组制备大鼠失血性休克模型,休克60 min后进行液体复苏,复苏后3 h处死大鼠,支气管肺泡灌洗液(BALF)中性粒细胞计数,测定肺组织湿重( W)和干重( D),计算W∕D比值,检测髓过氧化物酶(MPO)活性和TNF-α、IL-1β和IL-6含量.取肺组织做病理切片,观察病理学结果.结果 与S组比较,NS组、RL组和RM组BALF中性粒细胞计数、肺W∕D比值、MPO活性和TNF-α、IL-1β和IL-6含量升高(P＜0. 05);与NS组和RL组比较,RM组BALF中性粒细胞计数、肺W∕D比值、MPO活性和TNF-α、IL-1β和IL-6含量降低(P＜0. 05).结论 失血性休克大鼠采用复方苹果酸林格液复苏时急性肺损伤程度较生理盐水和乳酸林格液复苏时轻.

abstractsObjective To evaluate the effect of resuscitation with Ringer′s malate solution on acute lung injury caused by hemorrhagic shock in rats. Methods Forty-eight SPF healthy male Sprague-Dawley rats, aged 7-9 weeks, weighing 280-320 g, were assigned into 4 groups ( n＝12 each) using a random number table method: sham operation group (group S), normal saline group (group NS), Ringer′s lac-tate solution group ( group RL) and Ringer′s malate solution group ( group RM). In NS, RL and RM groups, the model of hemorrhagic shock was established, and rats were resuscitated after 60 min of hemor-rhagic shock. Rats were sacrificed at 3 h after resuscitation, and bronchial alveolar lavage fluid ( BALF) was collected to count neutrophils. Lung tissues were obtained for determination of the wet∕dry weight ratio (W∕D ratio), myeloperoxidase (MPO) activity, and contents of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and IL-6. Lung tissues were obtained for examination of the pathological changes. Results Compared with group S, the neutrophil count in BALF, W∕D ratio, MPO activity and contents of TNF-α, IL-1β and IL-6 were significantly increased in NS, RL and RM groups ( P＜0. 05). Compared with NS and RL groups, the neutrophil count in BALF, W∕D ratio, MPO activity and contents of TNF-α, IL-1β and IL-6 were significantly decreased in NS and RL groups (P＜0. 05). Conclusion The severity of acute lung injury is reduced when Ringer′s malate solution is used for resuscitation as compared with that when normal saline and Ringer′s lactate solution are used in a rat model of hemorrhagic shock.