脓毒症兔的代谢改变研究

Metabolism of hypermetabolic sepsis of a rabbit model

目的建立内毒素(LPS)诱导的高代谢脓毒症兔模型,研究其代谢改变。方法16只健康新西兰兔随机分为两组,禁食12 h后于麻醉状念下分别行气管插管及颈动脉、颈静脉、股动脉插管,脓毒症组通过颈静脉以10 ng·kg^(-1)·min^(-1)速度注入LPS,对照组注射生理盐水,监测两组实验兔的体温、心率、呼吸、血压,同时测量其LPS、血糖、动脉血气、乳酸值,并且采用能量代谢仪监测其能量代谢值。结果脓毒症组的心率、体温增幅显著高于对照组(P＜0．05),两组间血压增幅的差异无显著性(P＞0．05)。脓毒症组的血糖、乳酸、LPS的增幅明显高于对照组(P＜0．05),二氧化碳分压(PCO_2)、HCO_3、剩余碱(BE)、氧消耗量、CO_2产生量、代谢率(EE)的降幅均显著高于对照组(P＜0．05)。两组间pH值、氧分压(PO_2)、氧饱和度(SaO_2、呼吸商(RQ)消耗量增幅或降幅的差异均无显著性(P＞0．05)。结论LPS微量连续输注法可成功建立脓毒症兔模型,并能表现出明显的高代谢改变。

Objective To establish a hypermetabolic sepsis model of rabbit by continuous intravenous LPS infusion and to evaluate the metabolic changes. Methods Fasting 12 h New Zealand White rabbits were anesthetized with insertion of catheters into the right carotid artery, the right external jugular vein and the right femoral artery as well as trachea intubation under aseptic technique. All together 16 healthy ones were randomly divided into septic group and controlled group. Each of the septic group received LPS （Escherichia coli 0111： B4,10ng·KG^-1·min^-1）or saline （controls） and volume replacement over 3 h to reproduce hypermetabolic sepsis, and that of the controlled group only received saline. Results During the continuous LPS infusion, the body temperature and heart rate were significantly higher than those of the control. Significant increase in plasma lactate （P 0.05） and glucose （P〈0.05） occurred during the LPS infusion and also a significant decrease of arterial PCO2 （P〈0.05）, bicarbonate （P〈0.05）, BE （P〈0.05） 02 consumption （P〈0.05）, CO2 production （P〈0.05） and the resting energy expenditure （P〈0.05） were present during the hypermetabolic sepsis, but with moderate increase of pH value in the two groups caused by the significantly higher increment of respiratory rate. Conclusion The continuous LPS infusion is a convenient and highly efficient method to reproduce the rabbit model of hypermetabolic sepsis with numerous metabolic changes.