参附注射液对实验犬心原性休克血流动力学的影响  

Effect of shenfu injection on hemodynamics in dogs with cardiogenic shock

作　　者：殷文朋[1] 李春盛[1] 刘沐芸 

机构地区：[1]首都医科大学附属北京朝阳医院急诊科,北京100020 [2]三九药业有限公司

出　　处：《中华急诊医学杂志》2008年第1期45-49,共5页Chinese Journal of Emergency Medicine

基　　金：卫生部999中药注射液科研基金资助项目（200302）

摘　　要：目的用HemosoniCTm100经食道超声多普勒血流动力监测仪观察参附注射液对实验犬心原性休克血流动力学及氧代谢的影响。方法建立犬急性心原性休克模型，建模成功后分为3组：参附组、多巴胺组和对照组。于建模前、建模成功（给药即刻）、给药后30、60、90、120、180min各时间点通过HemosoniCTm100经食道超声多普勒血流动力监测仪进行血流动力学监测，观察实验犬的血流动力学变化，包括主动脉血流量（ABF）、心率（HR）、主动脉每搏输出量（SVa）、血流加速度（Acc）、左室射血时间（LVET）、与主动脉内全身循环阻力（TSVR），并于上述时间测定动、静脉血气值并计算氧输送（IM），氧耗量（Vo2）及氧摄取率（ERo2）进行前后比较。结果对照组在建模前与建模后即刻及各个时间点相比较，Acc、CO、SVa在造模之后各个时间段均进行性下降（P〈0．01），而TSVR、LVETi、HR在造模后各个时间段进行性升高（P〈0．01）。静脉注射参附注射液后SVa、Acc、MBP明显增加，60min时达到最高，然后逐渐下降（P〈0．01），TSVR、HR在用药后开始下降，30min时降到最低后开始逐渐升高，120min时到达用药前状态，LEVTi在参附组较另两组降低明显（P〈0．01）。静脉注射多巴胺后Acc、SVa、MBP、HR均增加，30min时达到最高，但升高幅度较参附注射液组低（P〈0．05），TSVR、LEVTi较参附组明显增加（P〈0．05）。在用药即刻三组Vo2与Do2均低于用药前，ERoz增高，与多巴胺比较参附组，Do2、Vo2在60、120min时显著升高（P〈0．05），ERo则明显下降P〈0.05）。结论参附注射液较多巴胺在增加心输出量、降低外周阻力、降低肺动脉阻力和HR，及改善组组织灌注与氧代谢能力方面有明显的优势。Objective To study effects of Shenfu injection on hemodynamics in dogs with cardiogenic shock by HemusonicTm100. Method The models of acute myocardial infarction were produced by ligating left coronary artery. Shenfu injection 1 ml/kg, dopamine 10 ug/kg-min, 0.9% Nacl injection 5 ml/kg were intravenously administered to the dogs in Shenfu group （ n = 6）, dopamine group （ n = 6）, and control group （ n = 6）, respectively, when the cardiogenic shock was found by the HemusoniCTm100. The aortic blood flow （ABF）, heart rate （HR）, stroke volume （SVa）, blood flow acceleration （Acc）, left ventricle ejection time （LVET）, total systemic vascular resistance （TSVR） were observed before establishing models, and at 0, 30, 60, 90, 120, and 180 minutes after administration. The blood gas and the results of Do2, V o2 and ERo2 were measured at the above time points. Results Copmared with before establishing models, Acc, CO, SVa gradually decreased in the control group after establishing the models （ P 〈 0.01 ）, while TSVR, LVET and HR increased （ P 〈 0.01 ）. SVa, Acc, and MBP of Shenfu group obviously increased, and peaked at 60 minutes after administration, and then gradually decreased, while TSVR and HR decreased, and reached the lowest level at 30 minutes and then gradually increased, and returned the to the original level atl 120 minutes. LVET of Shenfu group was obviously lower than that in the other two groups （ P 〈 0.01 ）. Acc, SVa, MBP and HR of dopamine group increased, and peaked at 30 minutes after administration, but were lower than those of Shenfu group （ P 〈 0.05）, TSVR and LEVTi were higher than those of the Shenfu group （ P 〈 0.05）. At 0 minutes after administration, Vo2 and DO2 of the three groups were lower than before administration, while ERo2 increased obviously. Compared with dopamine group, Vo2 and Do2 of Shenfu groups at 60 minutes and 120 minutes were higher, while ERo2 was lowe （ P 〈 0.05）. Conclusions Shenfu injection has a beneficial

关 键 词：参附注射液 心肌梗死 心原性休克 血流动力学 经食道超声多普勒 犬 

分 类 号：R285.5[医药卫生—中药学]