创伤性休克兔血浆一氧化氮的动态变化及亚甲蓝的干预作用

Dynamic changes of plasma nitric oxide in rabbits with traumatic shock and the intervention of methylene blue

目的观察创伤性休克兔血浆一氧化氮(nitricoxide,NO)的动态变化及鸟苷酸环化酶抑制药亚甲蓝(MethyleneBlue,MB)的干预作用。方法选用大白兔18只,分为对照组(6只),生理盐水复苏组(6只),MB处理组(6只),生理盐水复苏组及MB处理组记录休克前(T1)、休克末(T2)、复苏末(T3),复苏后0.5h(T4)、2h(T5)、4h(T6)时间点收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)及心率(HR)的动态变化,并测定血浆NO的水平,对照组记录相应时间点SBP、DBP、MAP及HR的动态变化,并测定血浆NO的水平。结果兔创伤性休克后,血浆NO水平明显高于休克前,生理盐水复苏组动物复苏后血浆NO进行性增高,于复苏后30分钟达峰值水平,以后逐渐下降,但仍高于休克前;MB处理组动物复苏后血浆NO水平明显降低;对照组各时间点血浆NO无明显变化。结论NO在创伤性休克的病理发展过程中起着重要作用,应用MB可降低血浆NO的水平,有助于创伤性休克的改善。

Objective To observe the changes of plasma nitric oxide in rabbits with traumatic shock and the intervention of methylene blue(MB), a guanylate cyclase inhibitor. Methods Eighteen rabbits were randomly assigned into 3 groups that control group, traumatic shock resuscitation with normal saline group (NS group) and traumatic shock resuscitation with methylene blue group (MB group). In NS group and MB group, to record systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MAP) and heart rate(HR), and NO of plasma were measured at pre-shock, tele-shock, tele-resuscitation, 0.5 hour, 2 hours and 4 hours after resuscitation. In control group, SBP, DBP, MAP and HR were recorded, and NO of plasma were measured in corresponding to courses of traumatic shock groups. Results The levels of plasma NO in rabbits after traumatic shock were very higher than pre-shock. In NS group, the levels of plasma NO after resuscitation were progressively increased, and reached peak level at 0.5 hour after resuscitation, then decreased, but still to remain higher level than pre-shock. But in MB group, the levels of plasma NO after resuscitation were obviously decreased. In control group, there weren’t significant changes about the levels of plasma NO among all courses. Conclusion NO plays an important role in the pathological process of traumatic shock, and the application of MB after resuscitation can decrease plasma NO level.