猪心脏移植中供体急性脑死亡模型的初步研究

A Preliminary Study on Acute Brain Death Model of Pig for Heart Transplantation

目的建立猪心脏移植供体的急性脑死亡模型，观察急性脑死亡前及后1、5、10min时的血流动力学和血浆中儿茶酚胺释放的变化并进行初步探讨。方法采用30～40k的猪8只，急性脑死亡前为对照组，急性脑死亡后为实验组。测定脑死亡前基础水平及脑死亡后1、5、10min时血流动力学改变和血浆中儿茶酚胺释放的变化，并对二者的变化进行初步探讨。结果急性脑死亡后1min时血流动力学及儿茶酚胺水平改变最明显，心率增加了88％，收缩压升高了132％，心排量增加了80％，肾上腺素（E）和去甲肾上腺素（NE）分别升高240％和241％，多巴胺（DA）没有明显增加。随后二者均持续下降，至10min时已降至基础水平以下。血流动力学改变的程度及时间分布与儿茶酚胺中的肾上腺素和去甲肾上腺素一致。结论急性脑死亡可造成机体血流动力学及血浆儿茶酚胺水平的剧烈改变，血中儿茶酚胺含量升高是造成急性脑死亡后血流动力学改变的原因，其中E和NE与血流动力学改变直接相关。

Objective The aim of this study was to observe hemodynamic changes and release of blood catecholamine within 10 minutes after acute brain death in pig for heart transplantation and discuss their relationship. Methods Pigs in weight of 30 - 40 kg were used in this study. The data before acute brain death were used as control group and the data after acute brain death were used as experimental group. The hemodynamics and blood catecholamine （CA） changes before and after brain death were measured to explore their relationship. Results The hemodynamics and release of blood catecholamine changed apparently in 1 minute after brain death. Heart rate was increased by 88%, blood pressure by 132%, cardiac output by 80%, epinephrine （E） and nor-epinephrine （NE） by 240% and 241% after brain death. Dobamine was not changed apparently. The time course and hemodynamic level changes were in coincidence with blood catecholamine releasing. Conclusion Hyperdynamic response and abnormal cathecholamine releasing occur after acute brain death. The hemodynamic changes may be directly correlated due to epinephrine and nor-epinephrine.