机构地区:[1]陕西省宝鸡市中心医院急诊科,721008 [2]陕西省宝鸡市第三人民医院消化科 [3]徐州医学院附属医院急救中心&徐州医学院救援医学研究所
出 处:《国际麻醉学与复苏杂志》2012年第5期303-307,共5页International Journal of Anesthesiology and Resuscitation
基 金:徐州市社会发展基金资助项目
摘 要:目的研究不同剂量盐酸戊乙奎醚(penehyclidinehydrochloride,PHC)对创伤性休克兔肠黏膜损伤的保护作用。方法采用Lamson’s法建立创伤性休克动物模型,30只健康日本长耳大白兔,采用随机数字表分为5组(每组6只):对照组(Con组),0.9%氯化钠溶液复苏组(NS组),低剂量组(PHCL组)(0.05mg,kg)、中剂量组(PHCM组)(0.15mg/kg)和高剂量组(PHCH组)(0.45mg/kg)。分别在休克前(T1),休克末(|r2),复苏后即刻(L)、2(T4)、4(L)、6h(T6)等6个时间点监测平均动脉压(MAP)和心率(HR)并采血检测二胺氧化酶(diamineoxidase,DAO)活性和D晋L酸浓度。实验结束后放血处死动物取小肠组织,光镜下检查病理学变化。结果各实验组动物R点的MAP显著降低(均≤45mmHg)(1mmHg=0.133kPa);T3-6点NS组的MAP分别是(68.8±3.0)、(67.5±5.3)、(71.0±3.7)、(71.0±2.4)mmHg,显著低于休克前(94.3±1.7)mnlHg、Con组(82.8±4.1)、(89.8±6.6)、(82.4±3.3)、(94.4±6.2)mmHg和PHCM组(83.2±13.6)、(82.2±9.0)、(83.8±8.9)、(85.4±8.1)mmHg,差异有统计学意义(P〈0.05或P〈0.01)。T3-6点NS组的HR(185±11)、(181±7)、(164±13)、(164±13)次/min较休克前(276±13)次/min显著降低,与Con组和PHCM组比较差异有统计学意义(P〈0.05或P〈0.01)。T2-6点各实验组动物的血浆DAO活性和D哥L酸浓度较休克前显著升高;T3-6点NS组的血浆DAO活性(0.393±0.020)、(0.586±0.017)、(0.844±0.036)、(0.568±0.016)μ/ml和D晋L酸浓度(8.292±0.364)、(7.539±0.098)、(5.991±0.180)、(7.108±0.372)mmol/L显著高于PHCL组和PHCH组,后两组又显著高于PHCM组(0.111±0.016)、(0.302±0.020)、(0.501±0.014)、(0.183±0�Objective To investigate the protective effects of penehyclidine hydrochloride(PHC) on intestinal mucosa injury in rabbits with traumatic shock. Methods The animal model of traumatic shock was established according to Lamson's method. Thirty rabbits were divided into five groups randomly: control group (Con group), traumatic shock group resuscitation with normal saline (NS group), traumatic shock group resuscitation with penehyclidine hydrochloride in low dosages (0.05 mg/kg, PHCL group),middle dosages group (0.15 mg/kg, PHCM group) and high dosages group (0.45 mg/kg, PHCH group). At pre-shock, post- shock, four time points (T3-T6) after resuscitation, mean arterial blood pressure(MAP) and heart rate (HR) were monitored. Plasma diamine oxidase (DAO) activity and lactic acid concentration were measured by spectrophotometry at defined time points. At the end of experiment, the animals were sacrificed and the samples were collected. The pathological changes of the samples were observed under microscope. Results There were no significant differences in MAP before shock among the five groups. MAP in NS group,PHCL group, PHCM group and PHCH group decreased posthock, but there were no significant differences in MAP among groups. At T3-T6 time points, MAP in NS group (68.8±3.0), ( 67.5±5.3 ), ( 71.0±3.7 ), (71.0±2.4) mm Hg( 1 mm Hg=0. 133 kPa ), respectively was significantly lower than that before shock (94.3±1.7) mm Hg, also lower than that in the Con group (82.8±4.1), (89.8±6.6), (82.4±3.3), (94.4±6.2) mm Hg, respectively and the PHCM group (83.2±13.6), (82.2±9.0), (83.8±8.9), (85.4±8.1) mm Hg, respectively. There were no significant differences in HR pre-shock and post-shock among the five groups. At T3-T6 time points, HR in the NS group ( 185± 11 ), ( 181±7 ), ( 164±13 ), ( 164± 13 ) bpm, respectively were significantly lower than that at T, ( 276± 13 ) bpm, also significantly (
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