法医学杂志

法医学杂志 ›› 2018, Vol. 34 ›› Issue (6): 625-630，634.DOI: 10.12116/j.issn.1004-5619.2018.06.010

• 论著 • 上一篇    下一篇

不同输液量救治失血性休克的肝组织相关代谢机制

李梦妮，胡智媚，庞  源，吴思浔，张  巧，苏锐冰，李纤纤，吴嘉燕，王  典，于晓军   

  1. 汕头大学医学院法医学教研室，广东 汕头 515041
  • 发布日期:2018-12-25 出版日期:2018-12-28
  • 通讯作者: 于晓军，男，博士，教授，博导，博士后合作教授，主要从事法医病理学研究；E-mail：xjyu@stu.edu.cn 王典，男，博士，副研究员，硕导，主要从事心脏性猝死代谢组学研究；E-mail：g_dwang@stu.edu.cn
  • 作者简介:李梦妮（1993—），女，临床医学专业本科生；E-mail：877362877@qq.com
  • 基金资助:
    国家级大学生创新训练计划资助项目（201210560079，201610560033）；“十二五”国家科技支撑计划子课题资助项目（2012BAK02B02）；2018年度第三批医疗卫生科技计划项目（汕府科[2018] 155号）；汕头大学医学院创新强校工程·重大项目培育计划NSFC青年基金培育资助项目（923-38040227）

Liver Tissue-related Metabolic Mechanism of Different Infusion Volumes for Hemorrhagic Shock

LI Meng-ni, HU Zhi-mei, PANG Yuan, WU Si-xun, ZHANG Qiao, SU Rui-bing, LI Qian-qian, WU Jia-yan, WANG Dian, YU Xiao-jun   

  1. Department of Forensic Pathology, Medical College, Shantou University, Shantou 515041, Guangdong Province, China
  • Online:2018-12-25 Published:2018-12-28
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摘要： 目的 探讨不同输液量救治失血性休克对肝组织相关代谢的影响。 方法 取30只家兔建立重度失血性休克模型，随机分为未输液组（A）、常量输液组（B）和过度输液组（C），每组10只，以常量输液组为对照，观察不输液和过度输液的危害。采用气相色谱-质谱法检测肝组织代谢物谱，分析3种不同情况与肝组织代谢变化的关系。 结果 过度输液组、未输液组的死亡率分别为70%和80%，常量输液组无死亡。过度输液组与常量输液组、未输液组的肝组织代谢轮廓差异有统计学意义。过度输液组肝组织代谢物中有21种低于常量输液组，8种低于未输液组。多种代谢物相对含量与输液量相关，琥珀酸含量与死亡相关（P<0.05）。 结论 常量输液救治失血性休克的疗效显著。过度输液肝组织代谢物普遍失代偿性降低，比未输液组家兔的存活时间长，可能是失血性休克后过度输液增加了血容量，组织液稀释是导致死亡的重要原因。

 

关键词: 法医病理学, 失血性休克, 肝, 代谢, 输液量, 兔

Abstract: Objective To investigate the curative effects of various infusion volumes on liver-related metabolic mechanism in the treatment of hemorrhagic shock. Methods A severe hemorrhagic shock rabbit model was established in 30 rabbits. The rabbits were randomly divided into three groups： non-infusion group （A）, conventional infusion group （B）, and excessive infusion group （C） （n=10 in each group）. Taking group B as the control, groups A and C were observed for the damage of non-infusion and excessive infusion, respectively. The outcomes in the three groups and their relations with liver tissue metabolism changes were analyzed with gas chromatograph-mass spectrometer （GC-MS）. Results The mortality in groups A, B, and C group were 80%, 0%, and 70%, respectively. The liver tissue metabolic profile in group B showed statistically significant difference compared with that in groups A and B. In group C, the levels of 21 metabolites were lower than those in group B, and the levels of 8 metabolites were lower than those in group A. The relative contents of various metabolites were correlated with infusion volumes, and the succinic acid content was associated with death events （P<0.05）. Conclusion The conventional infusion has significant curative effect on hemorrhagic shock. The metabolites of liver tissues with excessive infusion are generally decompensated and have longer survival time than those in non-infusion group, which may caused by the excessive infusion-induced blood volume increase after hemorrhagic shock. Tissue fluid dilution is an important cause of death.

Key words: forensic pathology, hemorrhagic shock, liver, metabolism, infusion quantity, rabbits

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