不同剂量去甲肾上腺素对脓毒症休克兔肠系膜微循环的影响  

Effects of different dosage noradrenalin on mesenteric microcirculation in rabbits with septic shock

作　　者：方华[1] 范开亮[2] 金灵燕 孔立[2] 董晓斌[2] 郭秀芹[1] 杨卉卉[1] 

机构地区：[1]山东中医药大学,济南250355 [2]山东中医药大学附属医院

出　　处：《临床医学》2017年第4期113-116,共4页Clinical Medicine

基　　金：2013年山东省医药卫生科技发展计划面上项目(2013WS0250);2011年;2013年山东省中医药科技发展计划项目(2011-095;2013-080);2012年山东省科技发展计划项目(2012YD19011)~~

摘　　要：目的研究不同剂量去甲肾上腺素对脓毒症休克兔肠系膜微循环的影响。方法将75只新西兰大白兔随机抽取15只为正常对照组,余60只为造模组,采用兔耳缘静脉注射脂多糖(LPS)制造兔脓毒症休克模型,造模成功后将其随机分成四组,分别为低剂量组[0.5μg/(kg·h)]、中剂量组[1.5μg/(kg·h)]、高剂量组[3.0μg/(kg·h)]和实验对照组,治疗组给予不同剂量去甲肾上腺素治疗,正常对照组及实验对照组给予等量氯化钠注射液。监测给药后1、3、6 h各兔平均动脉压、心率、乳酸、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平变化。通过BI-2000医学图像分析系统观察给药后3、6 h脓毒症休克兔肠系膜微动静脉血色、管径、流速、流态、毛细血管网交点开放数,观察给予不同剂量去甲肾上腺素治疗后各项指标的变化。结果与造模实验对照组、低剂量治疗组及高剂量治疗组比较,中剂量去甲肾上腺素组能明显降低脓毒症休克兔乳酸、TNF-α、IL-8水平,能更好的改善脓毒症休克兔微静脉及微动脉管径,增快血流速度,使毛细血管交叉网点开放数明显增多,差异有统计学意义(P<0.01)。结论中剂量去甲肾上腺素治疗可以明显改善脓毒性休克动物模型的微循环状况。Objective To observe the effects of different dosage noradrenalin on mesenteric microcirculation in rabbits with septic shock. Methods Fifteen New Zealand white rabbits were randomly selected as normal control group from the all 75 rabbits, and the remaining 60 rabbits as model group. The rabbit models of septic shock were established by injecting lipopolysaccharide （LPS） through ear vein. When models were established, they were randomly divided into four groups： low dose group, middle dose group, high dose group and experimental control group, and then they were given different dosage of noradrenalin ： low dose group 0. 5 μg/（ kg · h ）, middle dose group 1.5 μg/（ kg · h ）, high dose group 3.0 μg/（ kg · h）, normal control group and experimental control group were given equivalent saline. Then the changes of mean arterial pressure, heart rate, serum lactic acid （Lac）, tumor necrosis factor （TNF-α）, IL-8 level were observed at 1, 3, 6 h after the rabbits were given noradrenalin, and the opening number of mesenteric artery and vein diameter, velocity, flow pattern, junction of capillary network of rabbits with septic shock at 3,6 h were observed by BI-2000 image analysis system. Results Compared with experimental control group, low dose group and high dose group, middle dose group can significantly reduce the serum Lac, serum TNF-α, serum IL-8 levels and dilate the mesenteric microcireulation of arteriovenous diameter, accelerate the velocity, increase the opening number of capillary network junction in rabbits with septic shock, and the scores were significantly different （P 〈 0. 01 ）. Conclusion Middle dosage of noradrenalin can improve the microeireulation in animal model with septic shock.

关 键 词：脓毒症 休克 兔 微循环 去甲肾上腺素 

分 类 号：R459.7[医药卫生—急诊医学]