促甲状腺素释放激素对肺挫伤合并休克犬心肺功能的影响

Effects of TRH on Cardiopulmonary Function Following Pulmonary Contusion and Shock in Dogs

目的：探讨促甲状腺素释放激素（ＴＲＨ）对肺挫伤合并休克时心肺功能的影响．方法：实验共用１４只成年犬，建立犬肺挫伤合并休克模型．动物随机分为两组：对照组（８只），单纯肺挫伤合并休克组；ＴＲＨ组（６只），肺挫伤合并休克ＴＲＨ治疗组．于治疗前后测定心肺功能，并于治疗后４小时活杀动物，取心、肺标本进行病理学检查及肺水含量测定．结果：（１）ＴＲＨ组平均动脉压（ＭＡＰ）、心排指数（ＣＩ）等血液动力学指标明显高于对照组．（２）ＴＲＨ组潮气量（ＶＴ）、动态肺顺应性（ＤＬＣ）、动脉血氧分压（ＰａＯ２）等呼吸功能指标明显高于对照组．（３）两组肺水含量、肺血管阻力（ＰＶＲ）等指标无显著性差别．结论：ＴＲＨ在不扩容条件下既能有效地纠正休克，又不加重肺水肿，甚至在一定程度上能改善呼吸功能．值得进一步研究并临床应用．

Aim: To study the effects of thyrotropin releasing hormone (TRH) on cardiopulmonary function fol lowing pulmonary contusion and shock in dogs. Methods: The models of pulmonary contusion (PC) and shock were made and two groups of dogs were used as follows: TRH group: Six dogs were made for PC and shock and treated with 5 mg TRH. Control group: Eight dogs were made for PC and shock and had equal volume of normal saline. Then, the changes of cardiopulmonary function in TRH group were compared with those in control group. The dogs were killed at 4th hour after treatment. Results: (1) Mean arterial pressue (MAP), cardiac index (CI), etc. in TRH group were much higher than those in control group. (2) Tidal volume (VT), arterial oxygen partial pressure (PaO 2), etc. in TRH group were much higher than those in control group. (3) There was no significant difference in pathology, lung water and pulmonary vascular resistance (PVR) between the two groups. Conclusion: (1)TRH has antishock effect through enhancing myocardial contractility and improving cardiac function and hemodynamics. (2) TRH can improve pulmonary function and general condition, relieve hypoxemia and metabolic acidosis through improvement of circulatory function. (3) TRH will not cause pulmonary vascular contraction and may consequently prevent pulmonary hypertension and pulmonary edema.