早期脓毒症大鼠脑氧代谢与乳酸的变化  

Preliminary study of cerebral oxygen metabolism and change of blood lactate in early stage of sepsisin rats

作　　者：钱欣[1] 郑峥[1] 汤罗嘉[2] 陈锋[1] 

机构地区：[1]福建医科大学省立临床医学院,福建省急救中心,福州350001 [2]复旦大学附属上海中山医院急诊科

出　　处：《中华急诊医学杂志》2011年第5期511-514,共4页Chinese Journal of Emergency Medicine

摘　　要：目的观察早期脓毒症大鼠脑氧代谢及乳酸水平变化规律及其临床意义。方法选用64只清洁级雄性SD大鼠，分为随机（随机数字法）对照组和脓毒症组，各组再分为3，6，12，24h时间组（n=8），脓毒症组腹腔注射格兰氏阴性菌脂多糖（LPS）溶液建立脓毒症大鼠模型，对照组注射等量生理盐水，在各时间点抽取颈内静脉和腹主动脉血送检血气分析，测定颈内静脉血氧饱和度（SjvO2）、动脉血氧饱和度（SaO2）及乳酸（LA）含量，并计算动脉一颈内静脉氧含量差（AVDO2）和脑氧摄取率（OEF），分析Sjv02，AVDO2，OEF及乳酸含量的变化。结果脓毒症组AVD02，OEF在3，6，12h高于对照组，差异具有统计学意义（P〈0．05），在24h低于对照组，差异具有统计学意义（P〈0．05）；SjvO2在3，6，12h低于对照组，差异具有统计学意义（P〈0．05）；SjvO2在24h回升，与对照组比较，无统计学意义（P〉0．05）。脓毒症组各时间点LA含量与对照组相比均有不同程度升高，差异具有统计学意义（P〈0．05）。结论脓毒症早期可出现脑贯注及脑氧摄取的增强；SjvO2，AVDO2，OEF结合LA水平的监测，能更准确的评估脓毒症早期脑供氧、耗氧和脑贯注状态。Objective To observe the change of cerebral oxygen metablism and the level of blood lac- tate in early stage of sepsis in rats. Method Sixty-four SD rats were randomly （ random number） divided into septic group and control group. The sepsis model of rat was made by lipopolysaccharide （LPS, 10 mg/ kg） injected intra-abdominally, and rats of control group were treated with the same amount of physiological saline instead. And each group was further divided into 4 sub-groups of 4 h, 6 h, 12 h and 24 h after treatment. At each interval, blood samples were obtained via jugular vein for detecting blood oxygen saturation （SjvO2 ） and blood lactate （LA）. The blood oxygen saturation （SaO2） of ventral aorta was also measured. Arteriovenous oxygen content difference （ AVDO2 ） and oxygen extraction fraction （OEF） were studied. These four variables were analyzed and compared between two groups. Results The AVDO2 and OEF in sepsis group were higher than those in control groups of 3 h, 6 h and 12 h （P 〈0.05） , but lower than those in control group of 24 hours （ P 〈 0.05）. The SjvO： in sepsis group was lower than that in control groups of 3 h, 6 h and 12 h （P 〈 0.05）, but increased to that in control group of 24 h （P 〉 0.05）, LA in sepsis group was higher than that in control group in each interval （P 〈 0.05）. Conclusions In early stage ofsepsis, cerebral perfusion, cerebral oxygen supply and cerebral oxygen extraction increase. The global oxygen metabolic variables （ SjvO2, AVDO2 and OEF） and the level of LA can be used to objectively and accurately evaluate the cerebral oxygen metabolic dysfunction in early stage of sepsis.

关 键 词：脑氧代谢 颈内静脉血氧饱和度 动脉一颈内静脉氧含量差 脑氧摄取率 乳酸 脓毒症 格兰氏阴性菌脂多糖 血气分析 

分 类 号：R459.7[医药卫生—急诊医学]