不同剂量右美托咪定对脓毒症大鼠微循环的影响  

Effect of different doses of dexmedetomidine on microcirculation of rats with sepsis

作　　者：马燕[1] 拜合提尼沙.吐尔地[1] 于湘友[1] 王毅[1] 宋云林[1] Ma Yan;Baihetinisha·Tuerdi;Yu Xiangyou;Wang Yi;Song Yunlin(Department of Intensive Care Unit,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院重症医学科,乌鲁木齐830054

出　　处：《中华危重症医学杂志（电子版）》2018年第1期11-16,共6页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：国家自然科学基金项目(81160232);中华医学会临床医学科研专项资金-国瑞重症科研资金项目(13091520537);新疆维吾尔自治区自然科学基金项目(2005211C065)

摘　　要：目的探讨不同剂量右美托咪定对脓毒症大鼠微循环系统的影响。方法 48只Wistar大鼠按随机数字法分为盲肠结扎穿孔术(CLP)组、小剂量治疗组、中剂量治疗组和大剂量治疗组,每组12只。脓毒症模型采用CLP法进行制作,小、中、大剂量治疗组大鼠模型制作完成后,分别将右美托咪定以2.5μg·kg^(-1)·h(-1)、5μg·kg^(-1)·h(-1)和10μg·kg^(-1)·h(-1)的速度经尾静脉持续泵入。记录各组大鼠CLP术后1、3、5 h的平均动脉压和心率,以及CLP后3 h动脉血气包括p H值、二氧化碳分压、氧分压、细胞外液剩余碱、碳酸氢盐水平、总二氧化碳含量、氧饱和度及血乳酸水平,并计算24 h各组大鼠死亡情况。结果四组大鼠平均动脉压及心率水平比较,差异均有统计学意义(F=2.935、3.862,P=0.005、0.001)。与CLP组相比,小、中、大剂量治疗组大鼠的平均动脉压水平在术后1 h均显著降低(P均<0.05),但术后3、5 h比较差异均无统计学意义(P均>0.05);而心率则在术后3、5 h开始降低(P均<0.05)。CLP组大鼠术后3、5 h的平均动脉压较1 h均显著降低(P均<0.05),而小、中、大剂量治疗组大鼠术后3、5 h的心率均较同组1 h显著降低(P均<0.05),小、中剂量治疗组大鼠术后5 h的心率均较同组3 h显著降低(P均<0.05)。四组大鼠p H值[(7.27±0.07)、(7.17±0.08)、(7.12±0.07)、(7.13±0.07)]、二氧化碳分压[(38±8)、(72±21)、(77±24)、(83±16)mm Hg]、细胞外液剩余碱[(-9.7±3.9)、(-3.2±2.8)、(-4.7±3.4)、(-2.0±1.7)mmol/L]、碳酸氢盐水平[(17.4±3.3)、(25.0±2.7)、(24.7±4.2)、(27.1±1.7)mmol/L]、总二氧化碳含量[(18.6±3.7)、(27.1±2.8)、(26.9±4.9)、(29.6±2.1)mmol/L]、氧饱和度[(97.8±1.0)%、(97.2±1.5)%、(93.9±4.2)%、(94.4±4.0)%]及血乳酸水平[(94.45±4.01)、(0.63±0.66)、(0.63±0.43)、(0.45±0.38)mmol/L]比较,差异均有统计学意义(F=21.902、34.460、30.096、33.709、33.988、18.076、39.916,P均<0.05),而氧分压水平[(1Objective To evaluate the effects of dexmedetomidine at different doses on the early microcirculatory system in septic rats.Methods A total of 48 Wistar rats were randomly divided into the cecal ligation and puncture(CLP)group,small-dose treatment group,medium-dose treatment group and large-dose treatment group,12 rats in each group.The sepsis model was made by the CLP method,and dexmedetomidine was given respectively at the speed of 2.5μg·kg-1·h-1,5μg·kg-1·h-1 and 10μg·kg-1·h-1 to rats in small,medium and large-dose treatment groups through continuous tail vein pumping.The mean arterial pressure and heart rate at 1,3,5 h after CLP were recorded;arterial blood gas was measured at 3 h after CLP,including pH,partial pressure of carbon dioxide,partial pressure of oxygen,base excess in extracellular fluid,and levels of bicarbonate,total carbon dioxide,oxygen saturation and blood lactic acid;the death of rats in each group at 24 h was calculated.Results The heart rate and the level of mean arterial pressure in the four groups were significantly different(F=2.935,3.862;P=0.005,0.001).Compared with the CLP group,the mean arterial pressure of rats in small,medium and large-dose treatment groups decreased significantly at 1 h after operation(all P<0.05),but there were no significant differences among the three groups at 3 h and 5 h after operation(all P>0.05).However,the heart rate of rats in small,medium and large-dose treatment groups began to decrease at 3 h and 5 h after operation(all P<0.05).The mean arterial pressure in the CLP group at 3 h and 5 h after operation was significantly lower than that at 1 h(all P<0.05),while the heart rate of rats in the small,medium and large-dose treatment groups at 3 h and 5 h after operation was significantly lower than that at 1 h(all P<0.05).The heart rate at 5 h after operation in the small and medium-dose treatment groups was significantly lower than that at 3 h(all P<0.05).There were significant differences at the pH value[(7.27±0.07),(7.17±0.08),(7.12±0.07),(7.

关 键 词：休克 脓毒性 右美托咪定 微循环系统 

分 类 号：R614[医药卫生—麻醉学]