急性呼吸窘迫综合征时足三里穴及相关脏腑组织氧分压变化的实验研究  

An experimental study on changes of tissue oxygen partial pressure in Zusanli （ST36） acupoint and in its related organs in rabbits with acute respiratory distress syndrome

作　　者：董科奇[1] 邓杰[1] 竺静[2] 

机构地区：[1]浙江省舟山医院重症医学科,浙江舟山316021 [2]浙江海洋学院食品与药学学院、医学院,浙江舟山316022

出　　处：《中国中西医结合急救杂志》2015年第3期281-283,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省医药卫生科技计划项目（20058163）

摘　　要：目的观察急性呼吸窘迫综合征（ARDS）时经穴组织及相关脏腑组织氧分压变化的特点，阐明ARDS局部组织氧合情况与全身氧合情况的相关性及经穴组织和相关脏腑氧代谢的相关性。方法选择健康新西兰大白兔20只，按随机数字表法分为ARDS模型组和对照组，每组10只。采用颈静脉注射油酸（0．08～0．1mL／kg）的方法复制ARDS动物模型；对照组仅行气管切开、机械通气、动／静脉置管等操作而不给予油酸。用组织氧测定仪测定吸入氧浓度（FiO2）分别为0．21和1．00时两组足三里穴内、胃和肝组织的氧分压（PtO2），同时行动脉血和混合静脉血血气分析，计算氧摄取率（O2ER）。结果FiO2 0．21时ARDS模型组足三里穴内、胃和肝PtO2均明显高于对照组，动脉血氧分压（PaO2）、混合静脉血氧分压（PiO2）、动脉血氧饱和度（SaO2）、混合静脉血氧饱和度（SvO2）、O2 ER均明显低于同期对照组。FiO2 1．00时两组足三里穴内、胃和肝PtO：及PaO：、Sa02、O2 ER均较FiO，0．21时升高，以ARDS模型组足三里穴内、胃和肝PtO2、O2 ER水平升高更显著[PtO：（kPa）：足三里穴内：16．75±2．12比13．80±1．83，胃：16．45±1．33比13．35±1．25，肝：16．43±1．45比13．45±1．36，02ER：（36．14±0．97）％比（30．81±1．01）％]，Pa02、Sa02、S寻02以对照组升高更显著[Pa02（mmHg，1mmHg=0．133kPa）：682．02±50．32比159．32±40．17，SaO2：1．00±0．00比0．98±0．01，SiO20．59±0．01比0．63±0．03，均P〈0．05]。与本组FiO2 0．21时比较，ARDS模型组FiO2 1．00时NO，升高，对照组则降低，ARDS模型组和对照组比较差异有统计学意义（mmHg：36．00±2．83比42．50±1．70，P〈0．05）。且足三里穴内和胃PtO2呈正相关（r=0．963，p〈0，001）。结论ARDS时在全身性氧输送障碍情况下，脏腑组织氧需求显著增加，但氧利用明显障碍，这�Objective To observe the characteristics of changes in tissue oxygen partial pressure in Zusanli （ST36） aeupoint and related organs in acute respiratory, distress syndrome （ARDS）, and to clarify the correlation between oxygenation of local tissue and systemic oxygenation and the correlation between oxygen metabolism of aeupoint tissues and related organ tissues. Methods Twenty healthy New Zealand white rabbits were selected and divided into an ARDS model group and a control group, according to random number table method, 10 in each group. Oleic acid （0.08 - 0.1 mL/kg） intravenous injection was used to replicate the ARDS animal model. Only tracheotomy, mechanical ventilation, insertion of arterial/venous catheter, etc other manipulations were conducted, and no oleic acid was injected in the control group. Tissue oximeter was used to determine the fraction of inspired oxygen （FiO2）, when FiO2 was 0.21 and 1.00 respectively, the tissue oxygen partial pressure （PtO2） in Zusanli acupoint, stomach and liver was measured. Meanwhile, the blood gas analyses of arterial blood and mixed venous blood were carried out to calculate the oxygen extraction rate （O2ER）. Results When FiO2 was equal to 0.21, the levels of PtO2 in Zusanli acupoint, stomach and liver of the ARDS model group were significantly higher than those of the control group in the same period; the partial pressure of oxygen arterial blood （PaO2）, partial pressure of oxygen in mixed venous blood （P^O2）, arterial oxygen saturation （SaO2）, mixed venous oxygen saturation （SiO2） and O2ER of the ARDS model group were significantly lower than those of the control group over the same period. When FiO2 was equal to 1.00, PtO2, PaO2, SaO2 and O2ER in Zusanli acupoint, stomach and liver were increased compared with those when FiO2 was 0.21 in both groups, and the increase of PtO2 and O2ER in Zusanli acupoint, stomach and liver was more significant in the ARDS model group [PtO2 （kPa）： Zusanli acupoint： 16.75 ± 2.12 vs. 13.8

关 键 词：急性呼吸窘迫综合征 足三里穴 组织氧分压 氧代谢 

分 类 号：R563.8[医药卫生—呼吸系统]