海水浸泡对枪弹伤合并失血性休克大鼠血流动力学的影响及机制探讨  

Effects of sea water immersion on the hemodynamics of rats with gun shot and hemorrhagic shock

作　　者：卢青军[1] 陆松敏[1] 刘建仓[1] 李萍[1] 郭素清[1] 

机构地区：[1]中国人民解放军第三军医大学大坪医院野战外科研究所,重庆400042

出　　处：《中国急救医学》2002年第12期687-689,共3页Chinese Journal of Critical Care Medicine

基　　金：军队九五攻关课题 总后勤部科研基金资助项目 (No .96L0 0 4 )

摘　　要：目的　研究海水浸泡对枪弹伤合并失血性休克大鼠血流动力学、心肌细胞线粒体功能及一些生化指标的影响 ,探讨海水浸泡对心肌功能的影响及可能的机制。方法　健康Wistar雄性大鼠 2 0只 ,右侧大腿肌肉丰满处应用射钉枪造成贯通伤 ,包扎伤口。右侧颈总动脉插管至左心室 ,接四道生理记录仪 ,记录心肌力学的改变。左侧股动脉快速放血使血压降至 50mmHg(1mmHg =0 .1 33kPa) ,维持低血压 1h后 ,随机分为 2组 :海水浸泡组和陆地对照组 ,测定海水浸泡 5h大鼠平均动脉压 (MAP)、心率 (HR)、左室内压最大变化速率 (±dp·dt- 1 ·max- 1 )、左室收缩压 (LVSP)、心肌细胞线粒体呼吸功能、膜流动性 ,心肌组织Na+ -K+ -ATP酶活性、丙二醛 (MDA)含量及血浆乳酸脱氢酶 (LDH)。结果　海水浸泡 5h ,枪弹伤合并失血性休克大鼠MAP、HR、±dp·dt- 1 ·max- 1 、LVSP显著低于陆地对照组 ,心肌细胞线粒体呼吸控制率 (RCR)显著下降 ,膜脂区微黏度显著升高 ,心肌组织Na+ -K+ -ATP酶活性显著下降 ,心肌MDA含量和血浆LDH活力显著升高。结论　海水浸泡可以严重影响枪弹伤合并失血性休克大鼠血流动力学状态 。Objective To investigate the effects of 21℃ sea water immersion on the hemodynamics of rats with gun shot and hemorrhagic shock.Methods 20 rats with gun shot and hemorrhagic shock were divided into two groups:21℃ sea water immersion group(n=10) and land control group(n=10).After 5 hours the rats were immersed in 21℃ sea water,the mean arterial pressure (MAP),heart rate (HR),maximal rate of left ventricular pressure change(±dp·dt -1 ·max -1 ) and left ventricular systolic pressure (LVSP),the RCR and membrane fluidity of myocardial cell mitochondria,the activity of Na +-K +-ATPase and the MDA in myocardial tissue,the activity of plasma(LDH) of rats with gun shot and hemorrhagic shock were determined. Results Immersed in 21℃ sea water for 5 hours,the MAP?HR?±dp·dt -1 ·max -1 and LVSP of rats with gun shot and hemorrhagic shock were significantly decreased(P<0.01,vs land control group).The RCR,membrane fluidity of myocardial cell mitochondria and the activity of Na +-K +-ATPase in myocardial tissue were markedly decreased(P<0 05,vs land control group),but the content of MDA in myocardial tissue and the activity of plasma LDH were significantly increased(P<0 05,vs land control group).Conclusion 21℃ sea water immersion could aggravate the injury of myocardial tissue of rats with gun shot and hemorrhagic shock.

关 键 词：海水浸泡 枪弹伤 失血性休克 大鼠 血流动力学 

分 类 号：R826[医药卫生—临床医学]