生脉注射液对脓毒性休克绵羊血流动力学及氧代谢的影响

Effects of Shengmai injection(生脉注射液) on hemodynamics and oxygen metabolism in sheep with septic shock

目的探讨生脉注射液对脓毒性休克绵羊血流动力学及氧代谢的影响。方法用静脉注射内毒素脂多糖(LPS)的方法诱导绵羊脓毒性休克模型。以生脉注射液1 ml/kg缓慢静脉注射,观察治疗前以及治疗后即刻、30、60和120 min时绵羊血流动力学和氧代谢的变化。结果18只脓毒性休克绵羊给予生脉注射液后即刻出现平均动脉压(MAP)、平均肺动脉压(MPAP)、心排血指数(CI)、左室作功指数(LVSWI)、右室作功指数(RVSWI)均显著升高(P均<0.05),并在其后的120 min内保持稳定;中心静脉压(CVP)、肺动脉嵌顿压(PAWP)、体循环阻力指数(SVRI)、肺循环阻力指数(PVRI)在注射生脉注射液前后无明显改变(P均>0.05)。给药后即刻组织氧供给(DO2)就较给药前显著增加(P均<0.05),自给药后30 min组织氧消耗(VO2)显著增加(P均<0.05);氧摄取率(O2ER)和血中乳酸(Lac)水平无明显改变(P均>0.05)。结论生脉注射液可以通过改善心功能而显著改善脓毒性休克绵羊的血流动力学效应,同时通过提高DO2和组织利用氧的能力而改善组织氧代谢。

Objective To study the effect of Shengmai injection （生脉注射液,SMI） on hemodynamics and oxygen metabolism in sheep with septic shock. Methods In 18 sheep with septic shock induced by lipopolysaccharide （LPS）, hemodynamics and oxygen metabolism were observed before and at once, 30, 60 and 120 minutes after intravenous administration of 1 ml/kg SMI. Results After administration of 1 ml/kg SMI, mean systemic arterial pressure （MAP）, mean pulmonary arterial pressure （MPAP）, cardiac output index （CI）, left ventricular stroke work index （LVSWI）, right ventricular stroke work index （RVSWI）, were markedly increased （all P〈0.05）, and afterward remained stable for 120 minutes. No more changes were observed in central venous pressure （CVP）, pulmonary arterial wedge pressure （PAWP）, systemic vascular resistance index （SVRI）, pulmonary vascular resistance index （PVRI）, oxygen extraction index （O2ER） and lactic acid （Lac） （all P〉0.05）. At once after administration of the drug, the oxygen supply of the tissue, oxygen delivery index （DO2）, were significantly increased than those before the administration, and after 30 minutes of the administration, the tissue exhaustion was markedly elevated （all P〈0.05）. There was no significant difference in O2ER and Lac （both P〉0.05）. Conclusion SMI might have therapeutic effect in treatment of LPS induced septic shock in sheep by increasing CI and DO2.