| Objective:After major abdominal surgery in rabbits given early intervention hydroxyethyl starch. and with the saline group and blank control group for comparison. by observing the early mesenteric microvascular albumin leakage, measured mesenteric microvascular albumin leakage rate:detection of postoperative serum albumin protein concentration and serum concentrations of inflammatory mediators, understanding of hydroxyethyl starch on microvascular albumin leakage effects and possible mechanisms.Methods:18Japanese rabbits weight2.5±0.5kg. male. using a random number table. were randomly divided into three groups. namely control group. saline group. hydroxyethyl starch group. Groups after subtotal gastrectomy plus pancreatic body and tail, spleen resection. using isocaloric. isonitrogenous nutritional support. composed of glucose and fat calories150kcal provide.respectively. to provide heat for70%.30%. Nitrogen ratio of1:130heat. Saline group were given a daily25ml/Kg saline:hydroxyethyl starch group were given a daily6%HES (130.0.4)25ml/kg. blank control group was not given any intervention. just as albumin leakage rate testing.48h in the preoperative and postoperative serum albumin concentration and serum interleukin-6(Interleukin-6. IL-6). tumor necrosis factor-a (Tumour necrosis factor-a. TNF-a). interleukin-2(Interleukin-2. IL-2). vascular endothelial growth factor (Vascular endothelial growth factor. VEGF). intercellular adhesion molecule-1(Vntercellular adhesion molecule1.1CAM-1). histamine (Histamine. HIS) concentration:by intravenous injection of rhodamine isothiocyanate B (Rhodamine B isothiocyanate. RBITC) labeled bovine serum albumin (Bovine serum albumin. BSA) after the laser confocal microscope dynamic observation of rabbit mesenteric microvascular albumin leakage, and calculate its microvascular albumin permeability,results:1. Variations of the Serum Albumin concentration Preoperative albumin concentration: Control group:42.23±4.94g of/1hydroxyethyl starch group:41.73±3.52g/1, the difference was not statistically significant (p>0.05). Postoperative albumin concentration: Control group:30.47±4.44g/1, hydroxyethyl starch group:36.31±4.36g/1, the difference was statistically significant (p<0.05).2. Comparison of the rabbit mesenteric microvascular leakage rate: Preoperative leakage rate: Control group:0.572±0.600, hydroxyethyl starch group:0.60±0.039, the difference was not statistically significant (p>0.05). After leakage rate: Control group:1.90±0.184, hydroxyethyl starch group:1.69±0.107, the difference was statistically significant (p<0.05).3. Variations of the serum IL-6concentration: Groups in the preoperative IL-6concentration: Control group:12.16±1.55, hydroxyethyl starch group:11.45±2.77, the difference was not statistically significant (p>0.05). After the IL-6concentration: Control group:23.42±2.03, hydroxyethyl starch group:20.56±1.94, the difference was statistically significant (p<0.05).4. Variations of the serum TNF-a concentration: Preoperative TNF-a concentration: Control group:50.25±8.76, hydroxyethyl starch group:49.41±8.63, the difference was not statistically significant (p>0.05). Postoperative TNF-a concentration: Control group:81.61±6.04, hydroxyethyl starch group:72.81±6.16, the difference was statistically significant (p<0.05). 5. serum concentration VEGF Between the two groups: Saline and hydroxyethyl starch group with preoperative serum concentrations VEGF statistically significant difference (p>0.05). Saline group and postoperative serum VEGF hydroxyethyl starch concentrations were significantly different (p<0.05).Group comparison:VEGF saline serum concentrations before and after surgery were significantly different (p<0.01). Hydroxyethyl starch group before and after surgery VEGF serum concentrations were significantly different (p<0.01)6. serum concentration IL-2Between the two groups: Saline and hydroxyethyl starch group with preoperative serum concentrations IL-2statistically significant difference (p>0.05). Saline group and postoperative serum IL-2hydroxyethyl starch concentrations were significantly different (p<0.05). Group comparison: IL-2saline serum concentrations before and after surgery were significantly different (p<0.01). Hydroxyethyl starch group before and after surgery IL-2serum concentrations were significantly different (p<0.01)7.serum concentration HIS Between the two groups: Saline and hydroxyethyl starch group with preoperative serum concentrations HIS statistically significant difference (p>0.05). Saline group and postoperative serum HIS hydroxyethyl starch concentrations were significantly different (p<0.05).Group comparison:HIS saline serum concentrations before and after surgery were significantly different (p<0.01). Hydroxyethyl starch group before and after surgery HIS serum concentrations were significantly different (p<0.01)8.serum concentration ICAM Between the two groups: Saline and hydroxyethyl starch group with preoperative serum concentrations ICAM statistically significant difference (p>0.05). Saline group and postoperative serum ICAM hydroxyethyl starch concentrations were significantly different (p<0.05).Group comparison:ICAM saline serum concentrations before and after surgery were significantly different (p<0.01). Hydroxyethyl starch group before and after surgery ICAM serum concentrations were significantly different (p<0.01)Conclusion:1rabbit after major abdominal surgery early existence hypoalbuminemia, giving hydroxyethyl starch can be reduced after early after major abdominal surgery rabbit serum albumin concentration decreases;2rabbits given after major abdominal surgery hydroxyethyl starch may reduce early microvascular albumin leakage; after giving hydroxyethyl starch also significantly reduce early inflammatory mediators IL-6, TNF-α, IL-2, ICAM-1, VEGF increased range, suggesting that inflammatory mediators early after major surgery may be an important reason for microvascular albumin leakage. |
PDF Full Text Request