SMAO休克过程兔血浆NO、CO、H_2S和内毒素的动态变化观察  

The dynamic observation of NO,CO,H_2S and endotoxin in the blood plasma of rabbit during SMAO shock

作　　者：凌灿[1] 马琨[2] 张建龙[2] 刘晓洁[3] 刘帅[3] 刘冲[3] 何莉[3] 

机构地区：[1]新疆医科大学厚博学院机能教研室,新疆乌鲁木齐830011 [2]新疆医科大学基础医学院病理生理学教研室,新疆乌鲁木齐830011 [3]新疆医科大学厚博学院

出　　处：《新疆医科大学学报》2009年第4期391-393,共3页Journal of Xinjiang Medical University

基　　金：新疆医科大学大学生创新性实验计划项目

摘　　要：目的:观察肠系膜上动脉夹闭性休克(SMAO休克)过程兔血浆一氧化氮(NO)、一氧化碳(CO)、硫化氢(H2S)和内毒素的动态变化。方法:将40只新西兰大耳白兔随机分为5组:假手术组、缺血60min组(I组)、缺血60min再灌注30min组(I/R30min组)、缺血60min再灌注60min组(I/R60min组)、缺血60min再灌注120min组(I/R120min组),每组8只。检测SMAO休克过程各组兔动脉血压及血浆NO、CO、H2S和内毒素的动态变化。结果:与假手术组比较,I组动脉血压略降,再灌注各组血压进行性下降。实验各组血浆内毒素含量均明显增高,且随着再灌注时间的延长呈增高趋势(P<0.01)。I组血浆NO含量明显增高(P<0.01),再灌注后NO降低(P<0.01)。实验各组血浆CO均增高(P<0.01)。血浆H2S含量在I组明显增高(P<0.01),再灌注60min达到最高,而再灌注120min有所降低(P<0.01)。与血浆内毒素相关性分析显示:血浆NO呈负相关(r=-0.13),血浆CO及H2S呈正相关(r值为0.35和0.49,P<0.01)。结论:SMAO休克致内毒素血症,随着再灌注时间的延长血浆内毒素水平不断增高,进而引起机体内NO、CO和H2S的动态变化,造成机体损伤加重,因此临床上防治肠源性内毒素血症及内毒素性休克时,应在再灌注阶段实施有效的治疗。Objective： To observe the dynamic changes of nitric oxide （NO）, carbon monoxide （CO）, hydrogen sulfide （H2S） and endotoxin in the blood plasma of rabbit during SMAO shock. Methods： Forty rabbits were divided into 5 groups on radome： sham operated, ischemic 60 min, I 60 min/R 30 min, I 60 min/R 60min, I 60 min/R 120 min group, 8 rabbits in each group. Detected the dynamic changes of NO, CO, H2S and endotoxin in the blood plasma on rabbit during SMAO shock. Results： Compared with sham operated, the endotoxin eontent of blood plasma in each experimental groups increased obviously, and be came more higher with the reperfusion time prolonged （P 〈0.01） ; the NO content of the blood plasma incrased obviously in the ischemic group （P 〈0.01）, but decreased in the reperfusion group （P 〈0.01） ; the CO content of blood plasma in each experimental groups increased obviously （P 〈0.01） ; the H2S content of the blood plasma incrased obviously in the ischemic group （P 〈0.01）, arrived at the maxilum in the reperfusion 60 min, but decreased in the reperfusion 120 min group （P 〈0.01）. The relative analysis showed the endotoxin levels were negatively correlated with NO （r =-0.13） and positively corrlated with CO and H2S （r =0.35, 0.49）. Conclusions： SMAO shock induces endotoxemia, the endotoxin content increases endlessly with the reperfusion time prolonged, then induces the dynamic change of NO, CO and H2S in the organism, and makes the injure of organism aggravated. Therefore, the active treat enforces in the phase of reperfusion, while the prevention and cure of the endotoxemia drives from intestine and endotoxic shock should practice in the clinical therapy.

关 键 词：SMAO休克 内毒素 气体分子 动态变化 

分 类 号：R-332[医药卫生] R363