血管加压素院前维持血压对非控制性出血性休克大鼠的治疗作用  

Beneficial effects of pre-hospital administration of arginine vasopressin to maintain the blood pressure on uncontrolled hemorrhagic shock in rats

作　　者：杨光明[1] 李涛[1] 徐竞[1] 朱娱[1] 蓝丹[1] 吴跃[1] 刘良明[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所第二研究室,创伤,烧伤与复合伤国家重点实验室,重庆400042

出　　处：《中国临床药理学与治疗学》2015年第3期241-245,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：国家自然科学基金项目(81270400);国家自然科学基金青年基金项目(30901559);重庆市基础与前沿研究计划项目(cstc2013jcyjA10012)

摘　　要：目的:观察早期应用血管加压素(AVP)维持血压对非控制出血性休克大鼠的复苏效果。方法:SD大鼠120只随机分为5组:低压复苏对照组、低压复苏+AVP1×10-4、5×10-4、1×10-3和5×10-3 U/mL组。复制非控制出血性休克模型,分别用乳酸林格氏液/羟乙基淀粉(LR+HES)或加入不同剂量的AVP进行低压复苏(维持血压50mm Hg、3h,模拟院前救治阶段),然后彻底结扎止血、进行确定性治疗,维持血压80mm Hg、2h。观察院前阶段应用AVP维持血压对休克动物的出血及补液情况、存活情况和血流动力学指标的影响。结果:在非控制出血性休克的院前救治阶段,与单纯输注液体来维持血压相比,应用AVP维持血压能明显减少休克动物的出血量,减少在低压复苏期和确定性治疗期维持血压所需要的补液量;同时早期应用AVP也明显增加休克动物的存活时间和24h存活率,改善休克后血流动力学指标,包括左心室收缩压(LVSP)和左心室压力最大上升/下降速率(±dp/dtmax),其中5×10-4 U/mL的AVP的复苏效果明显高于单纯采用液体低压复苏的对照组。结论:院前救治阶段应用AVP维持血压对非控制出血性休克大鼠显示出较好的治疗效果。AIM：To investigate the effects of arginine vasopressin（AVP）on uncontrolled hemorrhagic shock in rats when used during the pre-hospital period.METHODS：One hundred and twenty SD rats were divided into 5groups：hypotensive resuscitation control group,AVP（1×10^-4,5×10^-4,1×10^-3 and 5×10^-3 U/mL）with hypotensive resuscitation groups.Uncontrolled hemorrhagic shock model was adopted,then shock rats were resuscitated with lactated Ringer＇s solution/hydroxyethyl starch with or without four doses of AVP（the blood pressure was maintained at 50 mm Hg for 3h,to mimic the pre-hospital treatment period）.At the end of hypotensive resuscitation stage,the bleeding was controlled and rats received fluid resuscitation to maintain the blood pressure at80 mm Hg for 2h（the definitive treatment period）.The effects of early treatment with AVP on blood loss,fluid requirement,animal survival and hemodynamics in uncontrolled hemorrhagic shock rats were observed.RESULTS：As compared with the hypotensive resuscitation control group,application of AVP reduced the blood loss and fluid requirement during the entire treatment period.And AVP also increased the survival time and 24-h survival rate of shock rats,and improved the hemodynamic parameter of shock rats including left intraventricular systolic pressure（LVSP）and maximal change rate of left intraventricular pressure（±dp/dtmax）.The best effect was shown with 5×10-4 U/mL of AVP.CONCLUSION：Early administration of AVP to maintain the blood pressure during the pre-hospital period has good beneficial effect on uncontrolled hemorrhagic shock rats.

关 键 词：非控制出血性休克 血管加压素 低压复苏 院前救治 

分 类 号：R965.2[医药卫生—药理学]