失血性休克对猪一氧化氮与内皮素的影响  

The effects of hemorrhagic shock on nitric oxide and endothelin in pigs

作　　者：李冬梅[1] 李文志[1] 郭悦平[1] 张莉莉[1] 周华成[1] 田野[1] 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科,150081

出　　处：《临床麻醉学杂志》2007年第4期314-316,共3页Journal of Clinical Anesthesiology

基　　金：黑龙江省教育厅资助(编号11511220)

摘　　要：目的探讨内源性一氧化氮(NO)与内皮素(ET)在失血性休克中的变化及其意义。方法14头体重为14～17kg的健康雄性家猪,随机均分为失血性休克组(H组)和对照组(C组)。H组按照Wigger’s改良法制作失血性休克模型,经股动脉快速放血使MAP降至40mmHg,维持90min,然后回输血液及等量的复方氯化钠。C组处理同H组,但未放血。各组分别在休克前、休克末、复苏末、复苏后30、60、120、240min记录MAP、HR、CVP、肺动脉压(PAP)、肺动脉楔压(PCWP)的变化,同时测定血浆NO与ET水平以及动脉血乳酸盐浓度(Lac)的变化。结果H组休克末MAP、PAP和CVP降低而HR升高,PCWP无显著变化。血浆NO水平在休克后逐渐升高,复苏后60min显著高于休克前和C组水平(P<0.05),此后一直维持较高水平,240min时达到高峰;休克后ET水平显著增加,并显著高于C组及休克前(P<0.05),复苏后逐渐下降。结论失血性休克后血浆NO、ET水平增加,在失血性休克的病理生理过程可有一定意义。Objective To observe the dynamic changes in plasma nitric oxide （NO） and endotbelin （ET） levels in pigs after hemorrhagic shock, and to explore their potential role in the pathogenesis of hemorrhagic shock. Methods Fourteen male healthy pigs weighing 14-17 kg were anesthetized and randomly divided into hemorrhagic shock group （group H,n=7） and control group （group C,n= 7）. The shock state （MAP= 40 mmHg ） was induced by controlled bleeding and maintained for 90 min. Then the shed blood was returned, followed by infusion of lactatic Ringer＇s solution, which is equal to the shed-blood volume. The animals in group C were treated as that in group H without artificial bleeding. MAP, HR, CVP, PAP and PCWP were monitored. The concentrations of ET and NO in the plasma were determined before, at the end of shock, immediately after resuscitation and at 30, 60, 120 and 240 min after resuscitation. The concentration of lactate was detected at the same time points. Results At the end of shock, MAP,PAP and CVP decreased, HR increased and PCWP remained as before in group H. There was a tendency of increase in NO and ET in piglets after hemorrhagic shock. The concentration of lactate was markedly increased at the end of shock, and declined after resuscitation. Conclusion It is suggested that increased concentration of NO and ET in the plas- ma might play an important role in the pathogenesis of hemorrhagic shock.

关 键 词：失血性休克 一氧化氮 内皮素 

分 类 号：R459.7[医药卫生—急诊医学]