氢溴酸山莨菪碱对脓毒性休克仔猪模型早期血流动力学的影响  

Effect of anisodamine hydrobromide on early hemodynamics of piglets with septic shock

作　　者：史清泉[1] 王明轩[2] 张志忠[2] 周杰 李春盛 王烁 Shi Qingquan;Wang Mingxuan;Zhang Zhizhong;Zhou Jie;Li Chunsheng;Wang Shuo(Department of Critical Care Medicine,Beijing Traditional Chinese Medicine Hospital,Capital Medical University,Beijing 100010,China;Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Infectious Diseases(Fever Clinic),Beijing Traditional Chinese Medicine Hospital,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院重症医学科,北京100010 [2]首都医科大学附属北京友谊医院急诊科,北京100050 [3]首都医科大学附属北京中医医院感染性疾病科(发热门诊),北京100010

出　　处：《中国医师杂志》2025年第2期173-177,共5页Journal of Chinese Physician

基　　金：北京市重大疫情防治重点专科(建设项目)(京卫医[2019]161号)。

摘　　要：目的研究和探讨氢溴酸山莨菪碱(654-1)、654-1+去甲肾上腺素、去甲肾上腺素对脓毒性休克仔猪早期的血流动力学指标的影响。方法选取38只健康巴马香猪作为研究对象,其中32只用脂多糖制造脓毒性休克仔猪模型,另外6只为假手术组。造模成功后的动物随机分为对照组(n=8)、药物处理组[654-1组(n=8)、654-1+去甲肾上腺素组(n=8)、去甲肾上腺素组(n=8)]。分别于T_(0)(基础状态)、T_(1)(休克造模成功时)、T_(2)(造模成功后1 h)、T_(3)(造模成功后2 h)、T_(4)(造模成功后4 h)、T_(5)(造模成功后6 h)、T_(6)(造模成功后8 h)时刻记录血流动力学参数,包括:平均动脉压(MAP)、心脏指数(CI)、全心舒张末期容积指数(GEDI)、乳酸(LAC)。结果除假手术组外,各处理组T_(1)时的MAP均显著低于T_(0)时(均P<0.05);各处理组T_(2)~T_(6)时的MAP均显著高于T_(1)时(均P<0.05);各处理组T_(1)时MAP均显著低于假手术组(均P<0.05);去甲肾上腺素组和654-1+去甲肾上腺素组T_(2)~T_(6)时MAP均高于对照组(均P<0.05),654-1组T_(2)~T_(4)时MAP显著低于654-1+去甲肾上腺组(均P<0.05)。除假手术组外,各处理组在T_(1)~T_(3)时的LAC较T_(0)时均显著升高(均P<0.05);654-1组T_(4)~T_(6)时的LAC较T_(1)时均显著降低(均P<0.05);在T_(4)~T_(6)时654-1组的LAC显著低于去甲肾上腺素组和对照组(均P<0.05)。去甲肾上腺素组在T_(2)、T_(5)、T_(6)时的CI较T_(0)时均降低(均P<0.05);T_(2)~T_(6)时的CI与T_(1)时差异无统计学意义(均P>0.05);654-1+去甲肾上腺素组在T_(4)时的CI较T_(0)显著降低(P<0.05);654-1组在T_(2)时的CI较T_(1)显著升高(P<0.05);654-1+去甲肾上腺素组T_(1)时的CI显著低于假手术组(均P<0.05)。654-1组T_(1)~T_(5)时的GEDI与T_(0)时比较差异有统计学意义(均P<0.05),654-1+去甲肾上腺素组T_(1)~T_(2)时的GEDI较T_(0)时明显降低(均P<0.05),而T_(2)、T_(4)时的GEDI较T_(1)时升高(均P<0.05)。结论脓毒性休克时,MAP明显下降,休克�ObjectiveTo investigate the effects of anisodamine hydrobromide(654-1),654-1+norepinephrine and norepinephrine on early hemodynamic indexes of piglets with septic shock.MethodsA total of 38 healthy Bama pigs were selected as the study subjects,32 of which were treated with lipopolysaccharide to create septic shock piglet model,and the other 6 were sham operation group.The animals were randomly divided into control group(n=8),drug treatment group[654-1 group(n=8),654-1+norepinephrine group(n=8),norepinephrine group(n=8)].Hemodynamic parameters were recorded at T_(0)(basic state),T_(1)(successful shock modeling),T_(2)(1 h after successful modeling),T_(3)(2 h after successful modeling),T_(4)(4 h after successful modeling),T_(5)(6 h after successful modeling)and T_(6)(8 h after successful modeling)respectively,including:Mean arterial pressure(MAP),cardiac index(CI),whole-heart end-diastolic volume index(GEDI),lactic acid(LAC).ResultsExcept for the sham operation group,MAP of all treatment groups at T_(1) was significantly lower than that at T_(0)(all P<0.05).MAP of all treatment groups at T_(2)-T_(6) was significantly higher than that at T_(1)(all P<0.05).T_(1) MAP of all treatment groups was significantly lower than that of the sham operation group(all P<0.05).MAP at T_(2)-T_(6) in the norepinephrine group and the 654-1+norepinephrine group was higher than that in the control group(all P<0.05),and MAP at T_(2)-T_(4) in the 654-1 group was significantly lower than that in the 654-1+norepinephrine group(all P<0.05).LAC of all treatment groups at T_(1)-T_(3) was significantly higher than that at T_(0)(all P<0.05)except the sham operation group.LAC in the group 654-1 at T_(4) to T_(6) was significantly lower than that at T_(1)(all P<0.05).LAC in the group 654-1 at T_(4)-T_(6) was significantly lower than that in the norepinephrine group and the control group(all P<0.05).The CI of norepinephrine group at T_(2),T_(5) and T_(6) was lower than that at T_(0)(all P<0.05).There was no significant difference in CI between T_(2)

关 键 词：休克 脓毒性 氢溴酸山莨菪碱 去甲肾上腺素 血流动力学 乳酸 

分 类 号：R54[医药卫生—心血管疾病]