TRH与HSAD用对高原失血性休克合并肺水肿大鼠的治疗作用  

Therapeutic effects of TRH plus HSAD on hemorrhagic shock combined with pulmonary edema in rats at high altitude

作　　者：胡德耀[1] 刘良明[1] 李萍[1] 刘建仓[1] 霍小萍[1] 刘厚东[2] 田昆仑[1] 石泉贵[2] 何燕梅[2] 周学武[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所第二研究室 [2]西藏军区总医院一外科,拉萨850003

出　　处：《第三军医大学学报》2004年第4期279-282,共4页Journal of Third Military Medical University

摘　　要：目的　研究促甲状腺素释放激素 (thyrotropin releasinghormone ,TRH)与高渗氯化钠 醋酸钠 右旋糖酐 40 (hy pertonicsodiumacetate /dextran 40 ,HSAD)伍用对急进高原失血性休克合并肺水肿大鼠的治疗作用。方法　实验在海拔3 760m的西藏拉萨市进行 ,急进高原大鼠 49只 ,从股动脉放血至 5 0mmHg ,静脉注射 5 μl/kg油酸制造肺水肿 ,维持该血压 1h ,复制失血性休克合并肺水肿模型。实验分为正常对照组 (不放血、不给油酸 )、单纯休克组、失血性休克合并肺水肿对照组、乳酸林格 ( 4ml/kg ,LR)对照组、TRH( 5mg/kg)组 ,HSAD( 4ml/kg)单用组和TRH与HSAD合用组 ,每组 7只动物。观察给药后 15、3 0、60、12 0min的血流动力学指标变化 ,3 0min和 12 0min的血气指标变化和 12 0min肺脑含水量变化。结果　TRH( 5mg/kg)与HSAD( 4ml/kg)单用或伍用 ,给药后MAP升高 ,LVSP、±dp/dtmax改善 ,酸碱平衡紊乱减轻 ,肺湿干质量比减少 ,其中两药伍用疗效在众多方面都比单独给药为强。结论　TRH与HSAD单用及伍用对高原失血性休克合并肺水肿大鼠有良好的抗休克及减轻肺水肿的作用 。Objective To investigate the therapeutic effects of thyrotropin releasing hormone (TRH) plus hypertonic sodium acetate /dextran 40 (5% NaCl, 3 5% NaAc, 6% Dextran 40, HSAD) on hemorrhagic shock combined with pulmonary edema in rats several days after arrival at the high altitude area. Methods A total of 49 SD rats, transported by air to Lhasa, Tibet, at 3 760 m above the sea level, were anesthetized one week later with sodium pentobarbital (30 mg/kg, ip). Hemorrhagic shock model combined with pulmonary edema was induced by hemorrhage (50 mmHg) plus intravenous injection of oleic acid (5 μl/kg) for 1 h. Rats were equally divided into 7 groups ( n = 7 in each group): normal control, hemorrhagic shock, hemorrhagic shock combined with pulmonary edema (HSPE), lactated Ringer's solution (4 ml/kg, LR), HSPE plus TRH (5 mg/kg), HSPE plus HSAD (4 ml/kg) , and HEPE plus TRH and HSAD. Hemodynamic parameters including mean arterial blood pressure (MAP), left intraventricular systolic pressure (LVSP), and the maximal rate of changes of intraventricular pressure (±dp/dt max ) were observed at 15, 30, 60 and 120 min after administration. Changes of blood gases were observed at 30 and 120 min, and the lung and brain water content was determined at 120 min after drug administration. Results TRH or HSAD used alone or in combination could significantly increase MAP, LVSP and ±dp/dt max ( P <0 05-0 01), attenuate disturbance of acid base balance, and decrease the lung and brain water content. The effect of the two used in combination was superior to that used alone. Conclusion TRH in combination with HSAD can result in good therapeutic effect on hemorrhagic shock combined with pulmonary edema in rats at high altitude.

关 键 词：高原 失血性休克 肺水肿 油酸 促甲状腺素释放激素 高渗氯化钠-醋酸钠-右旋糖酐40 

分 类 号：R453[医药卫生—治疗学] R541.63[医药卫生—临床医学]