复方丹参液对失血性休克家兔血流及氧动力学的影响

Effect of Complex Danshen(丹参) Solution on Oxygen Dynamics and Hemodynamics during Hemorrhagic Shock in Rats

目的:探讨复方丹参注射液改善失血性休克家兔氧动力学、血流动力学的可行性。方法:20只家兔随机分为丹参组和休克组。观察两组家兔休克前、休克即刻、休克1h、3h、6h、12h心指数(CI)、全身血管阻力指数(SVRI)、肺血管阻力指数(PVRI)混合静脉血氧饱和度(SvO2)、氧输送(DO2)、氧消耗(VO2)、氧摄取率(ERO2)、动脉血乳酸(LA)变化及DO2与VO2的关系。结果:休克组于休克1h时SVRI、PVRI、CI、DO2、SvO2较休克前无明显变化(P>0.05),于休克3h与休克前比较CI、DO2、SvO2显著降低,ERO2显著增加,(P<0.05),VO2保持不变,DO2与VO2呈非依赖关系。休克6h,当DO2降至397mL(min.m2)时,VO2明显降低,DO2与VO2线性相关,相关系数γ=0.62。丹参组于休克1h和3h时SVRI、PVRI、CI、DO2、SvO2与休克前比较无明显变化(P>0.05),于休克6h后,SVRI、PVRI、CI、DO2、SvO2降低,但与休克前比较无明显差异。丹参组休克后,CI、ERO2与休克前无显著改变。DO2、VO2显著升高。丹参组DO2与VO2亦呈线性相关(相关系数r=0.34,P<0.05。丹参组DO2、VO2关系曲线斜率明显低于休克组,相关系数明显降低。两组血乳酸水平于休克后1h无明显变化,于休克3h均明显升高(P<0.05),于休克后6h休克组血乳酸水平持续升高,丹参组较前下降,但高于休克前,于休克12h休克组达(8.70±0.73)mmol/L,丹参组下降至休克前水平。结论:失血性休克家兔出现血流动力学、氧动力学障碍,复方丹参注射液可改善这种状况。

Objective To investigate the feasibility of complex Danshen（丹参） solution for improving oxygen dynamics and hemodynamics in rats with hemorrhagic shock. Methods The rat model of hemorrhagic shock was set up, and 20 SD rats were randomized into two groups： Danshen solution and shock group 10 SD rats in each group. Parameters of cardiac index（CI）, systemic vascular resistance index（SVRI） pulmonary vascular resistance index（PVRI）, mixed ve- nous oxygen consumption（ SvO2 ）, oxygen delivery （DO2）, oxygen consumption（VO2）, ERO2, arterial blood lactase （LA） levels and the relation of DO2 to VO2 were detected. Results SVRI and PVRI immediately increased after shock. CI, DO2 and SvO2 were higher after shock for 1 h than those before shock. SVRI, PVRI and CI gradually decreased after shock for 3 h. DO2 and SvO2 descended along with CI decreasing. ERO2 proportionally increased, VO2 remained unchanged. VO2 did not depend on DO2. VO2 obviously cut down after shock for 6 h when DO2 was 397 ml/min, m^2. DO2 and VO2 remained linearly correlated （ r = 0.62）, SVRI and PVRI increased on shock and did not significantly decrease at advanced stage. DO2 and VO2 significantly increased, CI and ERO2 had no significant difference. DO2 and VO2 also r mained linearly correlated （ r = 0.34）. Blood LA level obviously increased, which were 4.09 ±0.52 mmol/L in shock group but 3.39 ± 0.33 mmol/L in Danshen group after shock for 3 h. Mter this, LA kept on increasing in shock group, up to 8.70±0.73 mmol/L after shock for 12 h. Conclusion Hemodynamic and oxygen dynamic disturbances developed in rats with hemorrhagic shock and complex Danshen solution may improve the condition.