雄激素在尿源性感染性休克进展中的作用研究  

The Role of Androgen in Uroseptic Shock

作　　者：袁杰[1] 俞世成[1] 张帅[1] 张磊[1] 王正会[1] 吴海洋[1] 朱世斌[1] 李恭会[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院泌尿外科,浙江杭州310016

出　　处：《泌尿外科杂志（电子版）》2016年第3期30-33,52,共5页Journal of Urology for Clinicians(Electronic Version)

基　　金：浙江省医药卫生科技计划项目(2015KYB222)支持

摘　　要：目的研究雄激素在尿源性感染性休克发生、发展及最终转归的影响。方法尿源性感染性休克模型-雄性新西兰兔共30只,随机分为对照组(A组)、实验组(B组、C组),每组10只,B、C两组在模型建立前2周进行去势手术,C组感染模型建立前24小时予十一酸双氢睾酮注射。分别测定术前术后平均动脉压,并分析对照组及各实验组死亡率。结果 A、B、C 3组去势前血清睾酮浓度无明显差异,去势2周后B组和C组中血清睾酮浓度与A组比较明显降低,C组注射睾酮24小时后血清中睾酮浓度和去势前浓度比较,没有统计学差异。B组术后各时间段中平均动脉压明显高于A组,出现休克的时间明显晚与A组;C组与A组相比,术后各时间段中平均动脉压和出现休克的时间没有统计学差异。A、B、C 3组,术后8小时自然死亡率分别为40%、0%和30%;术后10小时自然死亡率分别为90%、10%和80%;12小时自然死亡率分别为100%、60%和100%。结论在动物模型中,雄激素能够促进尿源性感染性休克的发生、发展,增加其死亡率。Objective Through comparing different hormone levels in the variation outcome of septic shock, we aim to explore the relationship between septic shock and androgen. Methods 30 male N e w Zealand rabbits were randomly assigned into control group A , experimental groups B and C . Rabbits in Group B and C under-went surgical castration prior to the operation and rabbits in Group C were injected testosterone 24 hours prior to the operation. Preoperative and postoperative m e a n arterial pressure, survival rates of all four groups were c o m-pared. Results There was no significant difference between group A and group B , C in serum testosterone level before castration. Two weeks after castration, serum testosterone level was significant lower in group B and C compared to group A . In group C , there was no significant difference in serum testosterone level between pre - castration and injection of exogenous testosterone 24 hours later. In the uroseptic shock m o d e l, M A P of all time sets in group B were significant higher than in group A ; there was no significant difference between group C and A in MAP of all time sets. Compared to group A , shock arrived m u c h later in group B , and there was no signifi-cant difference between group C and A regarding the time of shocks arrival. 8 hours post - operation death ratewere as following： 40% in group A , 0% in group B and 3 0 % in group C ; 10 hours post - operation deatwere as following; 90% in group A , 10% in group B and 80 % in group C ; 12 hours post - operation deatwere as following： 100% in group A , 6 0 % in group B and 100% in group C . Conclusions In animal modelperiment, we found that androgen could promote the process of uroseptic shock and increase mortality.

关 键 词：感染性休克 雄激素 手术去势 

分 类 号：R459.7[医药卫生—急诊医学] R699[医药卫生—治疗学]