| Objective: After major abdominal surgery in rabbits given hydroxyethyl starch (130/0.4) and normal saline to intervene, By125I labeled bovine serum albumin tracer detect radioactive counting in rabbit lung, calculates the pulmonary microvascular leakage of albumin, and the detection of rabbit serum albumin concentration and serum inflammatory mediators concentration. Investigate the effects of hydroxyethyl starch on rabbit pulmonary microvascular leakage of albumin, serum albumin concentration and inflammatory mediators After abdomen major surgery technique early time.Methods; In this study,12healthy male Japanese big ear rabbits were randomly divided into saline group and6hydroxyethyl starch group6. Two groups of rabbits are underwent subtotal gastrectomy plus the body and tail of pancreas, splenectomy, after the technique all rabbits were isocaloric, isonitrogenous nutrition support, thermal150kcal provides by the glucose and the fat, provides the quantity of heat separately70%,30%.The nitrogen hot ratio is1:130. After the technique the physiological saline group rabbit gives the physiological saline25ml/kg every day, the ethylol starch group rabbit gives6%HES(130/0.4)25ml/kg every day. In preoperative and postoperative48h for blood tests:The concentration of serum albumin, the blood serum white blood cell lie between the element-6(IL-6), the tumor necrosis factor-alpha (TNF-a), the white blood cell lie between the element-2(IL-2), the intercellular space adhere the member-1(ICAM-1), blood vessel bast growth factor (VEGF), the histamine (HIS).After pumping blood inject125I labeled bovine serum albumin (125I-BSA) through the ear vein immediately, after5mins fully washes the rabbit lung and drifts away to call heavily, the physiological saline group rabbits and hydroxyethyl starch group rabbits were taken the same size(about1cm*1cm*1cm) lung organizes in rabbit lung at the same place, measured radioactive counts and records by gamma counter after weighing, calculated for each gram of lung tissue percent injected dose rate (%ID· g-1) to indirectly assess micro vascular albumin leakage.Results:1.The concentration of serum albumin Comparison in group:The physiological saline group postoperative serum albumin concentration was lower than that before treatment, with a significant difference (P<0.01); hydroxyethyl starch group postoperative serum albumin concentration was slightly lower, with statistical significance (P<0.05).Comparison between groups:Saline and hydroxyethyl starch groups preoperative serum albumin concentration difference was not statistically significant (P>0.05); groups of hydroxyethyl starch in postoperative serum albumin concentrations higher than the saline group, with significant statistical significance (P<0.01).2.The concentration of serum interleukin-2(IL-2) Comparison in group:The physiological saline group postoperative serum interleukin-2(IL-2) concentration was higher than that before treatment, with a significant difference (P<0.01); hydroxyethyl starch group postoperative serum interleukin-2(IL-2) concentration was slightly higher, with statistical significance(P<0.05). Comparison between groups:Saline and hydroxyethyl starch groups preoperative serum interleukin-2(IL-2) concentration difference was not statistically significant (P>0.05); groups of hydroxyethyl starch in postoperative serum interleukin-2(IL-2) concentrations lower than the saline group, with significant statistical significance (P<0.01).3.The concentration of serum interleukin-6(IL-6) Comparison in group:The physiological saline group postoperative serum interleukin-6(IL-6) concentration was higher than that before treatment, with a significant difference (P<0.01); hydroxyethyl starch group postoperative serum interleukin6(IL-6) concentration was slightly higher, with statistical significance(P<0.05). Comparison between groups:Saline and hydroxyethyl starch groups preoperative serum interleukin-6(IL-6) concentration difference was not statistically significant (P>0.05); groups of hydroxyethyl starch in postoperative serum interleukin-6(IL-6) concentrations lower than the saline group, with significant statistical significance (P<0.01).4.The concentration of Serum tumor necrosis factor alpha (TNF-a) Comparison in group:The physiological saline group postoperative serum tumor necrosis factor alpha (TNF-α) concentration was higher than that before treatment, with a significant difference (P<0.01); hydroxyethyl starch group postoperative serum tumor necrosis factor alpha (TNF-a)concentration was slightly higher, with statistical significance(P<0.05).Comparison between groups:Saline and hydroxyethyl starch groups preoperative serum tumor necrosis factor alpha (TNF-α)concentration difference was not statistically significant (P>0.05); groups of hydroxyethyl starch in postoperative serum tumor necrosis factor alpha (TNF-α)concentrations lower than the saline group, with significant statistical significance (P<0.01).5. The concentration of Serum vascular endothelial growth factor (VEGF)Comparison in group:The physiological saline group postoperative serum vascular endothelial growth factor (VEGF)concentration was higher than that before treatment, with a significant difference (P<0.01); hydroxyethyl starch group postoperative serum vascular endothelial growth factor (VEGF)concentration was slightly higher, with statistical significance(P<0.05).Comparison between groups:Saline and hydroxyethyl starch groups preoperative serum vascular endothelial growth factor (VEGF)concentration difference was not statistically significant (P>0.05); groups of hydroxyethyl starch in postoperative serum vascular endothelial growth factor (VEGF)concentrations lower than the saline group, with significant statistical significance (P<0.01).6. The concentration of Serum intercellular adhesion molecule-1(ICAM-1)Comparison in group:The physiological saline group postoperative serum intercellular adhesion molecule-1(ICAM-1concentration was higher than that before treatment, with a significant difference (P<0.01); hydroxyethyl starch group postoperative serum intercellular adhesion molecule-1(ICAM-1concentration was slightly higher, with statistical significance(P<0.05).Comparison between groups:Saline and hydroxyethyl starch groups preoperative serum intercellular adhesion molecule-1(ICAM-1concentration difference was not statistically significant (P>0.05); groups of hydroxyethyl starch in postoperative serum intercellular adhesion molecule-1(ICAM-1concentrations lower than the saline group, with significant statistical significance (P<0.01).7. The concentration of Serum histamine (HIS)Comparison in group:The physiological saline group postoperative serum histamine (HIS)concentration was higher than that before treatment, with a significant difference (P<0.01); hydroxyethyl starch group postoperative serum histamine (HIS)concentration was higher than that before treatment, with significant statistical significance (P<0.01).Comparison between groups:Saline and hydroxyethyl starch groups preoperative serum histamine (HIS)concentration difference was not statistically significant (P>0.05); groups of hydroxyethyl starch in postoperative serum histamine (HIS)concentrations slightly higher than the saline group, with statistical significance (P<0.05). 8.P er gram of lung tissue percent injected dose rate (%ID· g-1)Hydroxyethyl starch group per gram of lung tissue percent injected dose rate (%ID· g-1) lower than the saline group, with significant statistical significance (P<0.01) Conclusion:1.A major abdominal surgery early (postoperative48h) has the phenomenon which the serum albumin density reduces; the use of hydroxyethyl starch (130/0.4) can decrease of plasma lead albumin concentration reduced.2A major abdominal surgery early (postoperative48h) has the phenomenon which inflammatory mediators such as Interleukin-6and tumor necrosis factor-alpha, interleukin-2, intercellular adhesion molecule-1and vascular endothelial growth factor, histamine concentration increased; The postoperative use of hydroxyethyl starch can reduce the concentration of interleukin-6, tumor necrosis factor alpha, interleukin-2, intercellular adhesion molecule-1, vascular endothelial growth factor, but cannot suppress the histamine (HIS) density ascension.3. After major abdominal surgery using hydroxyethyl starch may relieve lung microvascular albumin leakage.. |
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