Linoleic acid and acute red blood cells injury: mechanism of hidden blood loss after artificial joint replacement

doi:10.3969/j.issn.2095-4344.2014.48.006

Abstract

Abstract:

BACKGROUND: Hidden blood loss frequently occurs after artificial joint replacement surgery, the resulting anemia may cause serious impact on postoperative rehabilitation. There are many different theories about the hidden blood loss, but the mechanisms are not clear.
OBJECTIVE: To study the effect of linoleic acid on red blood cells of rats and explore the pathogenesis of hidden blood loss after artificial joint replacement surgery.
METHODS: Fifty Spraque-Dawley rats were randomly divided into five groups. Control group (n=10) was injected with alcohol solution via the tail veins. Four test groups (n=10) were injected with 15 mmol/L, 30 mmol/L,
60 mmol/L, 90 mmol/L linoleic acid via the tail veins, to establish high-level linoleic acid models in vivo. Blood samples collected from the orbital vein were determined before injection and at 24, 48, 72 hours after injection. Changes of hemoglobin, red blood cell count, glutathione peroxidase activity, total superoxide dismutase activity and hydrogen peroxide in the blood samples were observed.
RESULTS AND CONCLUSION: Significant hidden blood loss occurred when the concentration was 60 mmol/L in the experimental group, with the hemoglobin and red blood cell count were sharply reduced in blood samples. The hemoglobin and red blood cell count were reduced in all the experimental groups and control group 24 hours after administration, while the experimental groups changed more obviously (P < 0.05); glutathione peroxidase activity, total superoxide dismutase activity and hydrogen peroxide were also significantly reduced in all groups, and the changes showed significant difference among them (P < 0.05). The hemoglobin and red blood cell count were relatively stable in control group and the experimental groups 48 hours after administration, while glutathione peroxidase activity, total superoxide dismutase activity and hydrogen peroxide were significantly decreased, and changes in the experimental groups were more notable (P < 0.05). Experimental findings show that elevated levels of linoleic acid in the blood cause acute oxidative damage of the red blood cells, which eventually lead to acute anemia and hidden blood loss.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: linoleic acid, erythrocyte, blood loss, surgical, arthroplasty, replacement, superoxide dismutase

CLC Number:

R318

Yuan Tao, Cong Yu, Zhao Jian-ning, Zhou Li-wu, Chen Shuang-shuang, Bao Ni-rong. Linoleic acid and acute red blood cells injury: mechanism of hidden blood loss after artificial joint replacement[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(48): 7739-7744.

Figures/Tables 3

2.1 实验动物数量分析 1个对照组和4个实验组共50只大鼠纳入实验，其中90 mmol/L亚油酸组大鼠中有5只大鼠在实验过程中于给药后几分钟死亡，其他各组大鼠均顺利采集样本，并对所有样本进行血红蛋白质量浓度和红细胞计数检测，采集数据。对各组样本的数据分析发现 30 mmol/L亚油酸组、60 mmol/L亚油酸组大鼠血红蛋白质量浓度和红细胞计数发生了显著变化，考虑发生了隐性失血，然后进一步检测分析对照组、30 mmol/L亚油酸组、60 mmol/L亚油酸组大鼠血液中谷胱甘肽过氧化物酶活力、总超氧化物歧化酶活力以及过氧化氢浓度的变化情况，探究隐性失血的机制。 2.2 结果分析实验组通过尾静脉给予不同的药物浓度，成功建立了大鼠隐性失血的模型，随着药物浓度的增加实验组红细胞计数及血红蛋白质量浓度变化愈加明显，当药物浓度为90 mmol/L时，半数大鼠发生死亡，主要表现为呼吸困难、口唇发绀、咯血、抽搐直至死亡，致死原因为肺栓塞。研究数据表明当药物浓度为60 mmol/L血红蛋白质量浓度变化显著(P < 0.05，图1)。对照组、亚油酸30 mmol/L组和60 mmol/L组血液样本做进一步检验分析。在给药前，各组大鼠体质量及血液检测指标之间无明显差异。给药后24 h，对照组及实验组血液中血红蛋白质量浓度、红细胞计数均有明显的下降(图1，2)，对照组下降分别约(8.5±2.3) g/L，(0.22±0.05)×1012 L-1，亚油酸组下降约(16.5±2.0) g/L，(0.65±0.15)×1012 L-1，实验组与对照组相比变化更明显(P < 0.05)；对照组和实验组中的谷胱甘肽过氧化物酶活力、总超氧化物歧化酶活力、过氧化氢浓度均明显下降且实验组变化更显著(P < 0.05，图3-5)。给药后48 h，实验组及对照组血液中的红细胞计数、血红蛋白质量浓度与给药后24 h相比变化差异均无显著"

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