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目的:探讨限制性输液复苏孕兔失血性休克时,机体内皮素(ET)、血管活性肠肽(VIP)的变化规律及对全身炎症反应综合征(SIRS)发生、发展的影响。方法:建立孕兔失血性休克模型,分别用限制性输液和传统输液方法复苏失血性休克孕兔,比较了两组于不同时间点ET、VIP的含量。结果:(1)急性失血后VIP血清浓度明显升高,经输液处理后血清VIP浓度开始下降,限制性输液组下降明显,与传统输液组比较,第3h,4h和8h,差异有统计学意义(P<0.05);(2)急性失血后ET血清浓度明显升高,经输液处理后血清ET浓度开始下降,限制性输液组下降明显,与传统输液组比较,第3h,4h和8h,差异有统计学意义(P<0.05)。结论:休克发生后,参与或加剧机体发病的体液因子ET、VIP循环水平均明显升高,限制性输液能降低循环ET、VIP水平,减少组织损伤和休克恶化程度,有利于机体促炎-抗炎介质平衡,有效阻断了SIRS的发生和发展。
Objective: To investigate the changes of endothelin (ET) and vasoactive intestinal peptide (VIP) and the effect on the occurrence and development of systemic inflammatory response syndrome (SIRS) during the resuscitation of hemorrhagic shock in pregnant rabbits by restrictive fluid infusion. Methods: The model of hemorrhagic shock in rabbits was established. The hemorrhagic shock pregnant rabbits were resuscitated by restrictive infusion and traditional infusion respectively. The levels of ET and VIP were compared between the two groups at different time points. Results: (1) VIP serum concentration increased significantly after acute blood loss, serum VIP concentration began to decrease after infusion treatment, and decreased significantly in restricted infusion group. Compared with traditional infusion group, the difference was statistically significant at 3h, 4h and 8h (P <0.05). (2) ET serum concentration increased significantly after acute blood loss. The concentration of ET in serum began to decline after transfusion, and decreased in restrictive transfusion group. Compared with the traditional transfusion group, the difference was significant at 3h, 4h and 8h There was statistical significance (P <0.05). Conclusions: After shock, the levels of ET and VIP circulating in body fluids that participate in or exacerbate the pathogenesis are obviously increased. The restrictive infusion can reduce the levels of circulating ET and VIP, reduce the degree of tissue damage and shock, and promote the proinflammatory and anti-inflammatory Inflammatory mediator balance, effectively blocking the occurrence and development of SIRS.