重度脓毒症时机体氧代谢障碍变化的防治研究

The Experimental Study on Effect of Oxygen Dysmetabolism in Severe Sepsis

目的:观察重度脓毒症对机体氧代谢的影响及中药益气活血解毒方对其防治作用。方法:8只犬随机分为脓毒症模型组(C组)及益气活血解毒汤治疗组(YHJ组)。实验动物于静脉注入内毒素制备重度脓毒症模型后30min、1h和2h时经Swan-Ganz导管测定心输出量,抽取动脉及混合静脉血标本测血气分析,计算机体氧代谢指标。结果:C组氧输送量(DO2)、氧耗量(VO2)和氧摄取率(ERO2)造模后30min即迅速下降,明显低于基础值,并维持低值水平。YHJ组DO2、ERO2和VO2始终接近正常基线水平。结论:重度脓毒症时可使动物氧摄取率急剧降低,用YHJ防治可有效地改善组织氧摄取率,从而显著改善脓毒症动物的能量代谢障碍。

Objective： To observe the effect of oxygen metabolism in severe sepsis and the prevention effect of traditional Chinese medicine of Yiqihuoxuejiedu （YHJ）. Methods： Eight dogs were divided into two groups randomly , 4 dogs for the severe the sepsis model group （C group ） and 4 dogs for the YHJ therapy group （YHJ group）. Endotoxin was injected into animals by vein to induce severe sepsis. The YHJ group was treated by Yiqihuoxuejiedu injection. The cardie output （CO）, arterial oxygen content, mixed venous oxygen content were detected by Swan-Ganz catheterization after 30 min,1 h and 2 h of endotoxin injection. The index of oxygen metabolism was calculated. Results： The oxygen delivery（DO2）, oxygen consumption （VO2）and oxygen extraetion（ERO2）in the C group decreased rapidly after 30 min ,and always under the normal level and kept the low Level. But DO2, ERO2 and VO2 were always close to the normal level in the YHJ group. Cohclusion： The oxygen extraction decreased sharply in severe sepsis animal, and YHJ can improve tissue oxygen extraction effectively,and then prevent tissue oxygen extraction energy dysmetabolism in severe sepsis obviously.