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    静脉留置针留置时间对白兔耳缘静脉血管的影响

    Effect of the intravenous indwelling needle on the vein vessels of rabbit ear margin

      摘要
    • 摘要:
      目的： 探讨静脉留置针留置时间对白兔耳缘静脉中血管内皮损伤标志物表达水平的影响。
      方法： 采用随机数字表法将60只新西兰白兔随机分为对照组、置管4 d组（置留4 d，输液4次）、置管6 d组（置留6 d，输液6次）、置管8 d组（置留8 d，输液8次）、置管10 d组（置留10 d，输液10次），每组12只。除对照组外，其它组白兔均需用留置针进行静脉穿刺处理。每次静脉输入30 mL 0.9%氯化钠溶液，输完后用2～3 mL 15 U/mL 肝素盐水封管。各组穿刺、静脉输注时间相同。全自动生化分析仪检测白兔耳缘静脉血中C反应蛋白（CRP）水平；ELISA法检测白兔耳缘静脉血清中肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-6、IL-4、转化生长因子-β（TGF-β)、6-酮—前列环素F1α(6-keto-PGF1α)、血栓素B2(TXB2）、内皮素-1（ET-1）水平及耳缘静脉血管中血管性血友病因子（vWF）、一氧化氮合成酶（NOS）水平；HE染色检测各组白兔耳源静脉血管病理变化；Western blotting检测耳缘静脉血管中血栓调节蛋白（TM）蛋白。
      结果： 与对照组比较，置管4 d组、置管6 d组CRP、TNF-α、IL-6、IL-4、TGF-β、6-keto-PGF1α、TXB2、ET-1、vWF、NOS水平、TM蛋白，静脉血管病理损伤差异无统计学意义（P ＞ 0.05）；与对照组比较，置管8 d组、置管10 d组静脉血管病理损伤严重，CRP水平、TNF-α、IL-6、TXB2、ET-1、vWF水平、TM蛋白表达均升高，IL-4、TGF-β、6-keto-PGF1α、NOS水平均降低（P ＜ 0.05）。
      结论： 静脉留置针留置时间多于8 d会造成白兔耳缘静脉血管内皮损伤。

       

      Abstract:
      Objective To investigate the effects of indwelling time of venous indwelling needle on the expression level of vascular endothelial injury markers in the auricular vein of white rabbits.
      Methods Using the random number table method, 60 New Zealand white rabbits were randomly included into control group, 4-day catheterization group (catheterization for 4 days, infusion for 4 times), 6-day catheterization group (catheterization for 6 days, infusion for 6 times), 8-day catheterization group (catheterization for 8 days, infusion for 8 times), 10-day catheterization group (catheterization for 10 days, infusion for 10 times) (12 rabbits each group). Except for the control group, the white rabbits in the other groups were treated with an indwelling needle for venipuncture. 30 mL of 0.9% sodium chloride was injected intravenously, and the tube was sealed with 2–3 mL of 15 U/mL heparin saline after each infusion. The time of puncture and intravenous infusion was the same in each group. The content of C-reactive protein in white rabbit ear vein blood was detected by automatic biochemical analyzer; the serum levels of tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-4, transforming growth factor-β (TGF-β), 6-keto-prostacyclin F1α (6-keto-PGF1α), thromboxane B2 (TXB2), endothelin-1 (ET-1), and levels of von Willebrand factor (vWF) and nitric oxide synthase (NOS) in marginal ear veins were measured using ELISA method. HE staining was used to detect the pathological changes of auricular veins in each group of rabbits. Western blot was used to detect the thrombomodulin (TM) protein in marginal ear veins.
      Results There was no statistical significance in the levels of C-reactive protein, TNF-α, IL-6, IL-4, TGF-β, 6-keto-PGF1α, TXB2, ET-1, vWF, NOS and TM protein, and venous vascular pathological injury among the 4-day catheterization group, 6-day catheterization group and control group (P ＞ 0.05). Compared with the control group, the pathological injury of venous vessels was severe, the levels of C-reactive protein, TNF-α, IL-6, TXB2, ET-1, vWF and TM protein increased, and the levels of IL-4, TGF-β, 6-keto-PGF1α and NOS decreased in the 8-day catheterization group and 10-day catheterization group (P ＜ 0.05).
      Conclusions Venous indwelling needle for more than 8 days can cause the vascular endothelial injury of ear margin vein in rabbits.

       

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