儿茶酚胺类药物对内毒素休克兔心肌的影响

Influence of catecholamines on myocardium in rabbits with endotoxin shock

目的探讨儿茶酚胺类药物对内毒素休克兔心肌的影响。方法用连续注射大肠杆菌内毒素(LPS)复制内毒素休克兔模型。分别采用多巴胺(DA),去甲肾上腺素(NE)以及多巴酚丁胺(DB)复合NE以最小剂量纠正血压。动物随机分为正常对照组(A组)、内毒素休克对照组(B组)、多巴胺治疗组(C组)、去甲肾上腺治疗组(D组)、多巴酚丁胺复合去甲肾上腺素治疗组(E组),每组7只。检测血清心肌肌钙蛋白浓度(cTnI)、心肌丙二醛(MDA)浓度。在实验结束时,活检取心肌组织,用光镜检查心肌组织形态学改变。结果儿茶酚胺治疗各组cTnI和MDA浓度显著高于正常对照组和内毒素休克组,cTnI浓度与儿茶酚胺使用剂量呈正相关。组织学检测显示儿茶酚胺治疗各组与内毒素休克组并无显著区别。结论儿茶酚胺类药物能够改善内毒素休克兔的血液动力学状态,但能加重心肌损害。

Objective To study the influence of catecholamines on myocardium in rabbits with endotoxin shock.Methods Endotoxin shock was replicated in rabbits by receiving a continuous infusion of E-coli lipopolysachaide(LPS). Dopamine(DA),norephephrine(NE), or a combination of dobutamine(DB) and NE was used in the lowest dose.The rabbits were randomly divided into normal control group (group A),endotoxin shock control group(group B),DA-treatment group(group C),NE treatment-group(group D),NE+DB treatment group(group E).with 7 rabbits each.The serum troponin I(cTnI) and myocardial malondialdehyde(MDA) concentration were measured.When the experiments finished,autopsy was performed, and myocardial tissue was examined under light microscope.Results Significantly increased cTnI and MDA levels were found in catecholamine treatment groups compared with those in normal control group or endotoxin shock control group (P<0.05).There were significant positive correlations between the dose of NE/DA with the levels of cTnI.There was no significant difference in histological findings between endotoxin shock control group and each catecholamine treatment group. Conclusion Catecholamines can improve hemodynamic status, but enhance myocardial damage in rabbits with endotoxin shock.