摘要
目的探讨丙酮酸乙酯(EP)对脓毒性休克犬组织氧合及灌注指标的影响。方法健康雄性杂种犬20只,用脂多糖(LPS)静脉注射复制犬脓毒性休克模型,随机分为对照组(n=8)和EP组(n=12)。对照组只接受林格液复苏;EP组除给予林格液复苏外加EP,首剂0.05g/kg,然后以0.05g·kg^-1·h^-1的量持续泵人。脓毒性休克模型稳定后记为0h,此后12h内每2h收集组织氧合及灌注指标:氧输送(DO2)、氧消耗(VO2)、血乳酸(Lac)水平、混合静脉血氧饱和度(SvO2)、尿量、胃黏膜pH值(pHi)、胃-动脉二氧化碳分压差(Pg-aCO2)。结果脓毒性休克模型建立后,DO2、VO2、SvO2、尿量明显下降(P均〈0.05)。Lac、Pg-aCO2明显上升(P均〈0.05)。EP组DO2逐渐回升,8h后与对照组比较差异仍有统计学意义(P〈0.05);VO2也有增加趋势,但与对照组比较差异无统计学意义(P〉0.05);SvO2逐渐上升,10h后已显著超过制模前水平,且与对照组比较差异有统计学意义(P〈0.05);Lac水平逐渐下降,8h后与对照组比较差异有统计学意义(P〈0.05);尿量在8h后明显增加,10h后与对照组比较差异有统计学意义(P〈0.05);pHi在6h后明显上升,且与对照组比较差异有统计学意义(P〈0.05);Pg-aCO2在休克后8h其升高程度较对照组低(P〈0.05)。结论EP可以改善脓毒性休克犬氧代谢及组织灌注。
Objective To investigate the effect of ethyl pyruvate (EP) on indices of tissue oxygenation and perfusion in dogs with septic shock. Methods Twenty dogs with septic shock induced by lipopolysaccharides (LPS) were randomly divided into two groups. Dog randomly received placebo (Ringer's solution; control group, n: 8) or EP in lactated Ringer's solution (0.05 g/kg loading dose over 10 minutes, thereafter 0.05 g^-1·kg^-1· h^-1 for 12 hours; EP treatment group, n= 12). Indices of tissue oxygenation and perfusion were monitored every 2 hours after basic measurements (pre-LPS), including oxygen delivery (DO2), oxygen consumption (VO2), serum levels of lactate (Lac), mixed venous oxygen saturation (SvO2), urine output, intramucosal pH (pHi), gastric-to-arteria partial pressure of carbon dioxide gap (Pg-a CO2). Results DO2, VO2, SvO2 and urine output dropped significantly after septic shock (all P〈0.05), but serum levels of Lac and Pg-aCO2 elevated markedly (both P〈0.05). DO2 increased gradually in EP group and there were significantly differences compared with control group after 8 hours (P〈0.05). VO2 showed such a tendency, but there was no statistically significant intergroup difference (P〉 0.05). SvO2 elevated gradually in EP group, even higher than those of pre-LPS after 10 hours and there were significantly differences compared with control group (P〈0.05). Serum levels of Lac decreased gradually and there was significant difference compared with control group after 8 hours (P〈0.05). Urine output increased in EP group after 8 hours, and such phenomenon did not happen in control group after 10 hours (P〈0.05). phi elevated to a higher level after 6 hours, and Pg-aCO2 elevated in the treatment group, and there were significantly differences compared with control group (both P 〈 0. 05). Conclusion EP infusion resulted in improved tissue oxygenation and perfusion in dogs with septic shock.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2008年第1期34-36,共3页
Chinese Critical Care Medicine
基金
广东省广州市科委基金资助项目(200323-E0301)