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Effect of fluid resuscitation on capillary permeability and vascular endothelial growth factor in dogs with septic shock
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- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 5
- DOI:
- 10.3760/j.issn:1003-0603.2007.05.005
- Key Word:
- 休克,感染性;毛细血管渗漏综合征;内皮生长因子;液体复苏;伊文思蓝
Abstract： 目的 观察不同液体对感染性休克犬复苏后血管通透性、血管内皮细胞生长因子(VEGF)的影响,探讨毛细血管渗漏综合征的发生机制及治疗措施.方法 采用肠穿孔腹膜炎法制备成年家犬感染性休克模型.将24只休克模型犬随机分为3组,制模成功后按20 ml·kg-1·h-1输入下列液体进行复苏,Ⅰ组为生理盐水;Ⅱ组为高渗盐水(体积分数为7.5%);Ⅲ组为中分子羟乙基淀粉(HES130/0.4),复苏成功后维持60 min.观察各组的用液量、复苏所需时间及停止复苏后维持时间;用酶联免疫吸附法(ELISA)检测血浆VEGF浓度.注射伊文思蓝(EB)30 min后处死动物,取肺脏观察肺组织病理学变化;并用免疫组化法观察VEGF蛋白表达情况;计算肺组织含水量,测定肺组织中的EB含量.结果 Ⅰ组用液量、复苏所需时间均显著高于其他组(P＜0.05或P＜0.01);Ⅲ组维持时间、肺组织含水量及EB含量均显著低于其他组(P＜0.05或P＜0.01).休克后血浆VEGF浓度较休克前显著升高,复苏后又明显降低,Ⅲ组复苏后2 h较其他组更为显著(P均＜0.05);复苏后各组肺组织切片VEGF表达较休克时减轻,Ⅲ组尤为明显.结论 与生理盐水、高渗盐水相比,HES130/0.4更有利于降低感染性休克犬的血管通透性,减轻肺水肿,降低VEGF.
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