Resuscitation with hydroxyethyl starch solution prevents bone marrow mononuclear apoptosis in a rat trauma-hemorrhagic shock model.
Resuscitation with hydroxyethyl starch solution prevents bone marrow mononuclear apoptosis in a rat trauma-hemorrhagic shock model.
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DOI：
10.1097/ta.0b013e3181a8b286
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发表时间：
2010-03
期刊：
影响因子：
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通讯作者：
L. Liang;Guo-dong Xu;Yun Zhang;Wei Chen;Junjian Li;T. Liang
中科院分区：
文献类型：
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作者：
L. Liang;Guo-dong Xu;Yun Zhang;Wei Chen;Junjian Li;T. Liang
背景：创伤性失血性休克（T/HS）与包括骨髓衰竭在内的多器官功能障碍有关。本研究观察了不同体积治疗后骨髓单核细胞（bmmnc）的凋亡和形态学变化。方法：雄性Sprague-Dawley大鼠左股骨骨折，连续出血30分钟诱导T/HS，然后用乳酸林格液（RL）、6%羟乙基淀粉溶液（HES）或5%白蛋白（ALB）复苏。采用流式细胞术、转移酶介导的dUTP镍端标记法、苏木精和伊红染色检测不同复苏液对复苏后24小时和48小时bmmnc细胞凋亡和形态学的影响。结果：在三个治疗组中，平均动脉血压的波动是均匀的。T/HS + RL组早期BMMNC凋亡比例在24小时和48小时显著升高（分别为24.65% +/- 5.41%和29.09% +/- 2.07%,p < 0.05），晚期BMMNC凋亡比例在48小时升高至13.43% +/- 2.82% （p < 0.05）。相比之下，单独HES复苏可显著减轻细胞凋亡。ALB复苏可减轻BMMNC的凋亡，但48小时后的晚期凋亡除外。使用转移酶介导的dUTP镍端标记法和苏木精和伊红染色，T/HS + RL组比HES或ALB组显示更多的凋亡bmmnc和形态学改变。结论：与RL和ALB相比，HES在T/HS后48小时内可预防BMMNC凋亡。这些发现为HES对T/ hs相关多器官功能障碍的干预机制提供了新的见解。
BACKGROUND : Trauma-hemorrhagic shock (T/HS) has been associated with multiorgan dysfunction, including bone marrow failure. This study examined apoptosis and morphologic alterations in bone marrow mononuclear cells (BMMNCs) with different volume therapies after T/HS. METHODS : T/HS was induced in groups of male Sprague-Dawley rats through a fracture of the left femur and continual bleeding for 30 minutes, followed by resuscitation with Ringer's lactate solution (RL), 6% hydroxyethyl starch solution (HES), or 5% albumin (ALB). Mean arterial blood pressure was monitored during the T/HS and resuscitation, and the impacts of various resuscitative fluids on apoptosis and morphology of BMMNCs at 24 hours and 48 hours after resuscitation were examined using flow cytometry, transferase-mediated dUTP nick-end labeling assay, and hematoxylin and eosin staining. RESULTS : Fluctuations in mean arterial blood pressure were homogenous among the three treatment groups. The percentage of early BMMNC apoptosis increased significantly at 24 hours and 48 hours (24.65% +/- 5.41% and 29.09% +/- 2.07%, respectively; p < 0.05), and the percentage of late BMMNC apoptosis increased to 13.43% +/- 2.82% (p < 0.05) at 48 hours in the T/HS + RL group. In contrast, resuscitation with HES alone dramatically attenuated the apoptosis. Resuscitation with ALB alleviated BMMNC apoptosis, except for late apoptosis at 48 hours. A greater number of apoptotic BMMNCs as well as morphologic alterations were shown using the transferase-mediated dUTP nick-end labeling assay and hematoxylin and eosin stain in the T/HS + RL group than in the HES or ALB groups. CONCLUSION : Intravascular volume replacement with HES showed prevention of BMMNC apoptosis at first 48 hours after T/HS compared with RL and ALB. These findings provide new insights into the intervention mechanism of HES on T/HS-related multiorgan dysfunction.