不同剂量5%苏打对脑膜炎双球菌感染性休克家兔心功能的影响  

Effect of 5% Sodium Bicarbonate Perfusion at Different Dose on Cardiac Function in Rabbits with Infective Shock by Meningococcs

作　　者：张运生[1] 刘岐山[1] 殷国庆[2] 钟备[2] 

机构地区：[1]南京铁道医学院医学科学研究所,南京210009 [2]南京铁道医学院附属南京第二医院,南京210003

出　　处：《南京铁道医学院学报》1999年第3期148-151,共4页Journal of Nanjing Railway Medical College

基　　金：江苏省卫生厅资助

摘　　要：目的：研究输注５ ％ 苏打对感染性休克家兔心功能的影响。方法：将新西兰家兔制成脑膜炎双球菌感染动物模型，６０ ｍｉｎ 后随机分成对照组、 Ｓｂ ５ ．０ 组（５ ％ 苏打５ ．０ ｍｌ·ｋｇ － １） 、 Ｓｂ ３ ．３ 组（５ ％ 苏打３ ．３ ｍｌ·ｋｇ － １） 、 Ｈｓ５ ．０ 组（３ ．５ ％ 氯化钠溶液５ ．０ ｍｌ·ｋｇ － １） 及 Ｈｓ３ ．３ 组（３ ．５ ％ 氯化钠溶液３ ．３ ｍｌ·ｋｇ － １） ，观察左心室峰压、平均动脉压、左室压最大变化速率。以治疗前所测值为基础，比较给药后３０ 、６０ ｍｉｎ 上述指标变化百分率。记录结束后取心肌作超微结构检查。结果：输液治疗后３０ ｍｉｎ 和６０ ｍｉｎ ， Ｓｂ ５ ．０ 组和 Ｈｓ５ ．０ 组上述观察指标比对照组显著降低，而 Ｓｂ ３ ．３ 和 Ｈｓ３ ．３ 组与对照组相比无差别。治疗后６０ ｍｉｎ Ｓｂ５ ．０ 组、 Ｈｓ ５ ．０ 组动物全部死亡，而另外３ 组全部存活。所有动物都可见相似的心肌损伤。结论：５ ％ 苏打及３ ．５ ％ 氯化钠高渗液体，５ ｍｌ·ｋｇ － １ 剂量均可加重脑膜炎双球菌感染性休克家兔的心功能损伤，故在感染性休克治疗中，使用５ ％ 苏打应谨慎。Objective:The experiment was designed to study the effect of 5% sodium bicarbonate on the cardiac function and myocardial damages in rabbits with infective shock by meningococcus (MC) .Methods:Animal models were established with New Zealand white rabbits and divided into five groups 60?min after MC challenging.1,control group,injected with normal saline ( n =10);2,Sb 5.0 group,injected with 5% sodium bicarbonate 5.0?ml·kg -1 ( n =5);3,Sb?3.3 group,injected with 5% sodium bicarbonate 3.3 ml·kg -1 ( n =10);4,Hs 5.0 group,injected with 3.5% sodium chloride 5.0 ml·kg -1 ( n =5);and 5,Hs 3.3 group,injected with 3.5% sodium chloride 3.3 ml·kg -1 ( n =10).The left ventricular pressure (LVP),mean arterial pressure (MAP) and maximum rate of changes of left ventricular pressure [(±dp/dt) max ] were registered in baseline (before treating),30 and 60 min after treating,respectivelly.And the ultrastructure of myocardium were examined by the end of register.Results:By 30 and 60 min after injection,the items of Sb 5.0 and Hs 5.0 group were significantlly decreasd,but no in difference those between Sb 3.3 and Hs 3.3 group and the control group were found.The survival rate of control,Sb 3.3 and Hs 3.3 groups was 100%,but no survival was found in the other 2 groups.Some similar myocardial damages were found in all the animals studied.Conclusion:Hypertonic perfusate,whether 5% sodium bicarbonate or 3.5% sodium chloride,in a dose of 5.0 ml·kg -1 may worsen the cardiac function in rabbits with infective shock by MC ,and the 5% sodium bicarbonate may be of limited therapeutic value in infective shock.

关 键 词：脑膜炎双球菌 感染性休克 治疗 苏打 心功能 

分 类 号：R631.405[医药卫生—外科学]