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目的:评价蛋白酶抑制剂乌司他丁对创伤性休克的治疗效果,并观察乌司他丁对血浆磷脂酶A2水解产物及细胞因子的影响。方法:30只新西兰白兔随机分为三组,对照组、创伤性休克组和创伤性休克乌司他丁治疗组,观察休克前后TXA2和PGI2,、TNF-α、IL-8的动态变化及乌司他丁对它们的影响。结果:对照组TNF-α、IL-8的血浆浓度和TXA2/PGI2的比值在整个实验期呈现增高趋势,但没有统计学意义。创伤性休克组和创伤性休克乌司他丁治疗组休克后TXA2、TNF-α、IL-8的血浆浓度分别在不同的时点较休克前有显著增高,其中乌司他丁治疗组的TXA2、TNF-α、IL-8血浆浓度均明显低于休克组。光镜及电镜下观察肺组织,乌司他丁治疗组较休克组的病理损害亦显著减轻。结论:在创伤性休克的发展过程中血浆磷脂酶A2水解产物及细胞因子起着重要作用,应用蛋白酶抑制剂乌司他丁有助于休克的改善反重要脏器的保护。
OBJECTIVE: To evaluate the effect of ulinastatin, a protease inhibitor, on the treatment of traumatic shock and to observe the effect of ulinastatin on plasma phospholipase A2 hydrolysates and cytokines. Methods: Thirty New Zealand white rabbits were randomly divided into three groups: control group, traumatic shock group and traumatic shock ulinastatin group. The changes of TXA2, PGI2, TNF-α and IL-8 before and after shock were observed. The influence of ulinastatin on them. Results: The plasma concentration of TNF-α and IL-8 and the ratio of TXA2 / PGI2 in the control group showed an increasing trend throughout the experimental period, but there was no statistical significance. The plasma concentrations of TXA2, TNF-α and IL-8 in the traumatic shock group and the ulinastatin-treated group were significantly higher than those before shock at different time points, respectively. The levels of TXA2, , TNF-α, IL-8 plasma concentrations were significantly lower than the shock group. Light and electron microscopy lung tissue, ulinastatin treatment group than in the shock group also significantly reduced pathological damage. CONCLUSIONS: Plasma phospholipase A2 hydrolysates and cytokines play an important role in the development of traumatic shock. The application of ulinastatin, a protease inhibitor, may help to improve the protection of vital organs against shock.