精氨酸血管加压素对非控制性出血性休克大鼠彻底止血后的复苏效果

AVP used in stage of definitive treatment for uncontrolled hemorrhagic shock

目的观察精氨酸血管加压素(arginine vasopressin,AVP)对非控制性出血性休克大鼠彻底止血后复苏效果。方法采用大鼠脾实质切除及脾动脉切断方法复制非控制性出血性休克模型,在止血前采用低压复苏(50mmHg,1h)后结扎血管彻底止血,观察乳酸林格氏液(Lactated Ringer’s,LR)、AVP(0.4U/kg和0.04U/kg)对大鼠血流动力学指标、血气指标、存活时间和存活率的影响。LR组在彻底止血后输注2倍失血量LR;AVP0.1U/kg组和0.4U/kg组在2倍量的LR中分别加入AVP0.4U/kg和0.04U/kg输注。结果非控制性出血性休克大鼠在休克后以及低压复苏后血流动力学指标包括左心室收缩压(left intraventricular systolic pressure,LVSP)、左心室压力上升或下降的最大速率(themaximal change rate of left intraventricular pressure,±dp/dtmax)明显低于休克前(P<0.05),血气也发生了明显改变;2倍失血量的LR输注不能较好地恢复平均动脉血压(mean artery pressure,MAP)和血流动力学指标,AVP0.4U/kg和0.04U/kg输注,明显增加MAP和改善休克大鼠血流动力学指标,延长休克动物存活时间并提高存活率,与LR组相比明显升高(P<0.05)。结论AVP对非控制性出血性休克大鼠彻底止血后有较好的复苏效果。

Objective To investigate the beneficial effect of arginine vasopressin （AVP） on uncontrolled hemorrhagic shock when used in the stage of definitive treatment in rats. Methods SD rats were used to make uncontrolled hemorrhagic shock by resection of the splenic parenehyma and one of the branches of splenic artery. Experiments were conducted by observing the resuscitative effects of Lactated Ringer＇s （LR）, AVP （0.4 or 0. 04 U/kg） on shock rats at the decisive treatment stage to search for the ideal treatment measures, Results AVP at the concentration of 0.4 U/kg and 0.04 U/kg can significantly improve the hemodynamic parameters including left intraventricular systolic pressure （LVSP） , the maximal change rate of left intraventrieular pressure （ ± dp/dt ） , and the 24-h survival rate of uncontrolled hemorrhagic shock rats in stage of definitive phase （P 〈 0.05） as compared with those in LR group. Conclusion AVP may be beneficial for the treatment of uncontrolled hemorrhagic shock.