亚甲蓝对创伤性休克兔血流动力学和脏器损伤的干预作用

Intervention of methylene blue on hemodynamics and visceral lesion in rabbits with traumatic shock

目的观察鸟苷酸环化酶抑制药亚甲蓝(MethyleneBlue,MB)对创伤性休克兔血流动力学和脏器病理形态学的干预作用。方法选用大白兔18只,分为对照组(6只),创伤性休克生理盐水复苏组(生理盐水复苏组6只),创伤性休克MB处理组(MB处理组6只),生理盐水复苏组及MB处理组观察休克前(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)、心率(HR)的动态变化,对照组观察相应时间点SBP、DBP、MAP、HR的动态变化。并留取小肠、肝脏组织,观察病理变化。结果3组动物SBP、DBP、MAP、HR基础值无明显差异(P>0.05)。对照组各相应时间点SBP、DBP、MAP、HR较基础值无明显变化(P>0.05)。生理盐水复苏组复苏末及复苏后各时间点SBP、DBP、MAP、HR均未达到基础值水平(P<0.05或P<0.01);复苏末及复苏后各时间点SBP、DBP、MAP与对照组比较有明显差异(P<0.01),复苏后2h及复苏后4hHR与对照组比较有明显差异(P<0.05);复苏后2h的SBP、DBP、MAP与MB处理组比较有明显差异(P<0.05或P<0.01)。MB处理组各相应时间点HR较基础值无明显变化(P>0.05),除复苏末HR与对照组比较有明显差异(P<0.01)外,其余各时间点HR与对照组比较无明显差异(P>0.05);复苏末SBP、MAP及复苏后4hDBP、MAP与基础值比较无明显差异(P>0.05);复苏末MAP及复苏后4hSBP、DBP、MAP与对照组比较无明显差异(P>0.05)。生理盐水复苏组各脏器病理损害明显;MB处理组各脏器病理损害显著减轻;对照组各脏器无明显病理损害。结论MB可明显改善创伤性休克血流动力学,保护重要脏器。

Objective To observe the intervention of methylene blue(MB), a guanylate cyclase inhibitor, on hemodynamics and visceral pathomorphology in rabbits with traumatic shock.Methods Eighteen rabbits was randomly assigned into 3 groups (n=6),namely 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) 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 in corresponding to courses of traumatic shock groups. Tissue samples of the liver and intestine obtained after experiments for microscopic examination.Results There weren't significant difference about basal SBP,DBP, MAP and HR among 3 groups (P>0.05).In control group, there weren't significant difference about SBP,DBP, MAP and HR among all courses (P>0.05). But in NS group, SBP,DBP,MAP and HR of tele-resuscitation and each after resuscitation time point vs basal all decreased(P<0.05 or 0.01); there were significant difference about SBP,DBP and MAP of tele-resuscitation and each after resuscitation time point vs control group (P<0.01); there were significant difference about HR of 2 hours and 4 hours after resuscitation vs control group (P<0.05); there were significant difference about SBP,DBPand MAP of 2 hours after resuscitation vs MB group(P<0.05 or 0.01).In MB group, there weren't significant difference about HR among all courses (P>0.05); there weren't significant difference about HR among courses (P>0.05) except for tele-resuscitation (P<0.01)compared with control group; there weren't significant difference about SBP and MAP of tele-resuscitation compared with basal (P>0.05) ,DBP and MAP of 4 hours after resuscitation were too not (P>0.05); compared with control group, there weren't significant difference about MAP of tele-resuscitation and 4 hours after resuscitation(P>0.05),SBP and DBP of 4 hours after resuscitation were too not (P>0.05).In NS group, the pathologic lesions of the organs were very obvious. But in MB group, there were less pathologic lesions of the organs, and in control group, there weren't obviously pathologic lesions of the organs.Conclusions MB can obviously ameliorate hemodynamics of traumatic shock, and protect the important organs.