米力农对肠系膜上动脉闭塞性休克兔肠道氧代谢的影响

The effect of milrinone on intestinal aerobic metabolism in SMAO Shock rabbits

目的米力农是磷酸二酯酶III抑制剂,许多研究认为能改善休克患者的血流动力学及全身的氧供、氧耗,但对肠道的氧供、氧耗的影响研究甚少。本研究旨在探讨米力农对肠系膜上动脉闭塞性(SMAO)休克兔肠道氧代谢的影响。方法16只健康家兔随机分为对照组和治疗组,经腹分离肠系膜上动脉复制SMAO休克模型。对照组静脉泵入米力农0.1ml·kg-1·min-1,治疗组静脉注入负荷量米力农50μg·kg-1,随后持续泵入米力农0.5ug·kg-1·min-1,液体总量和A组相同。实验期间于夹闭前-1h、松夹后休克时0h、松夹后1h、2h、定时观察MAP,HR,SMAF;测定肠系膜上静脉、颈内动脉血气,并根据公式计算出氧供(DO)2、和氧耗(VO)2。结果松夹后1-2h期间,治疗组较对照组MAP,HR,SMAF,肠道DO2及VO2明显升高(P<0.05或<0.01)。结论米力农能显著增加SMAO休克兔肠系膜上动脉血流量,提高肠道的氧供、氧耗、及全身血压,改善了缺血脏器的血供和氧合状态。

Objective Milrinone is an inhibitor of PDEⅢ, which has shown potentially favourable hemodynamic responses, the total oxygen delier （DO2）, oxygen consumption （VO2） . But the effect of milrinone on intestinal aerobic metabolism was few reported. The present study was therefore undertaken to investigate these problems in SMAO shock rabbits. Methods Sixteen healthy rabbits were duplicated the SMAO shock model, then randomly divided them into two group （n=8）： group A was control group; group B was remedied group. 50ug·kg^-1 of milrinone was infused and then continuously being pouring in milrinone 0.5ug·kg^-1·min^-1 while romoving artery clamp. During the experiment we observed the arterial blood stream amount （SMAF） on the mesentery, MAP, HR, arterial and venous blood gas analysis at before shock-1h, 0h, 1h, 2h; calculated the oxygen deliver （DO2）, oxygen consumption （VO2） by formula. Results During the 1-2hours after removed artery clamp, compared with group A, the MAP, HR, SMAF, DO2 and VO2 were increased （P〈0.05 or 〈0.01） .Conclusion In SMAO shock rabbits, milrinone can considerably increase the arterial blood stream amount （SMAF）, oxygen deliver （DO2）, oxygen consumption （VO2） and blood pressure, it may be beneficial to the treatemt of shock.