丹参总酚酸对兔急性呼吸窘迫综合征时心功能的影响

The effect of salvianolic acids on rabbit cardiac function during acute respiratory distress syndrome

目的探讨丹参总酚酸对兔急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)时心功能的影响及其可能机制。方法新西兰兔24只,分为对照组、ALI/ARDS组和丹参总酚酸干预组;经颈静脉注射油酸(OA,0.15mg/kg)复制兔ALI/ARDS模型,颈动脉插管至左心室,随时记录左室收缩末期压力(LVSP)、收缩末期左心室压力最大上升速率(+dp/dtmax)、舒张末期左心室压力最大下降速率(-dp/dtmax),开胸分离胸主动脉根部,套以内径适宜的电磁流量计探头,备测心输出量(CO),肺动脉根部插管备测平均肺动脉压(mPAP)。丹参总酚酸组于注OA前30min静脉注射丹参总酚酸(10mg/kg);各组于注OA后10、30、60、120min采血测定血浆丙二醛(MDA)含量,2h后取肺做病理检查。结果ALI/ARDS组兔在注射OA后10、30、60、120min各时间点,血浆MDA水平均显著高于对照组(P<0.01或P<0.05);注射OA后10min,CO开始降低,mPAP即见升高;至60min、120min时,+dp/dtmax和-dp/dtmax方明显低于对照组(P<0.01)。丹参总酚酸干预组与ALI/ARDS组比较,各时间点血浆MDA水平均见降低,而左心室功能于注射OA后60min、120min时则显著高于ALI/ARDS组(P<0.05),且与对照组比较差异无显著性(P>0.05)。结论ALI/ARDS兔存在心功能障碍,mPAP升高可能为其始动环节,可依次导致右心或左心功能降低;丹参总酚酸有助于改善心脏功能,其机制可能与其抗氧化功能有关。

Objective To investigate the effect of salvianolic acids on rabbit cardiac functions during acute lung injury(ALI)/acute respiratory distress syndrome(ARDS)and its mechanism.Method 24 rabbits were divided into three groups:the control group,the ALI/ARDS group and the salvianolic acids administration group.The rabbits of ALI/ARDS group were injected with 0.15 mg/kg of oleic acid(OA)through left jugular vein;while in salvianolic acids administration group,salvianolic acids were given 30 min before OA injections.Then insert the heparinized catheters into the left ventricules of the experimental rabbits,observe the changes of LVSP,(+dp/dtmax,)-dp/dtmax by the polygraph and plasma MDA levels by the assay kit at 10 min,30 min,60 min and 120 min after OA injections,respectively.Open thorax,dissect the root of the thoracic aorta,cuff the detecting head of electromagnetic flowmeter,then measure the CO.Insert the heparinized catheter into pulmonary artery,observe the change of mPAP.Result The level of mPAP began to increase at 10 min after OA injection and lasted for at least 120 min,the level of CO also showed decrease at 10 min after OA injection in ALI/ARDS group,while the levels of LVSP,+dp/dtmax and -dp/dtmax showed lowered only at 60 min and 120 min after OA injection(P<0.05 vs control);the plasma level of MDA was obviously rose from 10 min after OA injection(P<0.01 or P<0.05 vs control).In salvianolic acids administration group,the cardiac functions were much improved than that of ALI/ARDS group at 60 min and 120 min after OA injections(P<0.05),the plasma level of MDA was also lower than that of ALI/ARDS group at every time point,additionally,there were no difference in LVSP,+dp/dtmax,-dp/dtmax and MDA between salvianolic acids administration group and control group,despite that there were some differences in CO and mPAP between salvianolic acids administration group and control group.Conclusion There is cardiac dysfuntion in ALI/ARDS,risen mPAP might be its initiator that inducing right heart dysfunction and left heart dysfunction successively;salvianolic acids could improve the cardiac function,that might relate to the antioxidation effect of salvianolic acids.