【作者】 陈婷婷；

【导师】 王刚；

【作者基本信息】 中国人民解放军军医进修学院 ， 麻醉学， 2003， 硕士

【摘要】 第一部分：乌司他丁对创伤失血性休克兔内源性血管活性物质的影响 目的 评价蛋白酶抑制剂乌司他丁对创伤失血性休克的治疗效果，并观察乌司他丁对内源性血管活性物质的影响。方法 30只新西兰白兔随机分为三组，对照组、创伤失血性休克组和创伤失血性休克乌司他丁治疗组，观察休克前后TXA₂和PGI₂ET和ADM两组内源性血管活性物质的动态变化及乌司他丁对它们的影响。结果 对照组的各种内源性血管活性物质的血浆浓度在整个实验期无明显变化。创伤失血性休克组和创伤失血性休克乌司他丁治疗组休克后ET、ADM和TXA₂的血浆浓度分别在不同的时相点较休克前有显著增高（p＜0.05），其中乌司他丁治疗组的TXA₂和ET血浆浓度的增高均明显低于休克组（p＜0.05）。乌司他丁组的平均动脉压在复苏期较休克组有显著性增高（P＜0.05）。结论 内源性血管活性物质参与了创伤失血性休克的整个发展过程，并在休克过程中对血管舒缩及血液灌流起重要的调节作用，蛋白酶抑制剂乌司他丁可能通过抑制TXA₂和ET的升高，提高休克时的平均动脉压，并改善灌流。 第二部分：乌司他丁对创伤失血性休克兔肺损伤保护作用的研究 目的 观察蛋白酶抑制剂乌司他丁对创伤失血性休克兔细胞因子及黏附分子的影响，并探讨其对缺血再灌注肺损伤的保护作用。方法 30只新西兰白兔随机分为三组，对照组、创伤失血性休克组和创伤失血性休克乌司他丁治疗组，观察休克前后血清中细胞因子TNF-α、IL-8和sICAM-1的动态变化，并于复苏后4更多还原

【Abstract】 Part 1 Effects of Ulinastatin on plasma levels of lipid humoralfactors in traumatic hemorrhagic shock in rabbits Objective To evaluate the effects of Ulinastatin, a protease inhibitor, on plasma levels of lipid humoral factors in traumatic hemorrhagic shock. Methods Thirty rabbits were randomly divided into three groups, control group, traumatic hemorrhagic shock group and ulinastatin-treated group. Blood was sampled at four time points: pre-shock, post-shock, as well as 2h and 4h after blood volume compensation. Plasma levels of ET, ADM and TXA2, PGI2 were measured. Results In control group, the plasma concentrations of the four lipid humoral factors showed elevated changes in the duration of experiment, but without statistic significance. And in the other two groups , plasma levels of ET, ADM and TXA2 were significantly higher at the following three observed points than those before shock(p<0.05), while plasma levels of ET and TXA2 in ulinastatin-treated group were significantly lower than that in traumatic shock group(p<0.05). Conclusion Ulinastatin possesses beneficial effects in treatment of traumatic hemorrhagic shock, which maybe related to the reduction of the release of ET and TXA2.更多还原