腹部开放伤合并海水浸泡致犬急性心力衰竭的病理生理变化

Pathophysiological changes of dogs with open abdominal injury and seawater immersion-induced acute heart failure

目的:观察犬腹部开放性损伤经海水浸泡后致急性心力衰竭的一系列病理生理变化。方法:以成年杂种犬为实验对象,随机分为腹部伤+海水浸泡组(A组,n=8)和单纯腹部伤组(B组,n=8)。观察实验动物致腹部开放性损伤前、后,经海水浸泡2 h及打捞出水后不同时间点心律、心率、收缩压、舒张压、平均动脉压、肺动脉楔压、中心静脉压、心输出量、心脏指数、肾素、脑钠肽等相关指标及病死率。并于致伤前及致伤后4 h行超声心动图,测定左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、每搏输出量(SV)、左室射血分数(LVEF)。结果:致伤后0.5 h至观察终点,A组犬平均动脉压均明显下降(P<0.05,P<0.01),B组犬平均动脉压无明显变化。致伤后A组犬肺动脉楔压显著上升,其中心静脉压、心输出量、心脏指数逐渐下降,打捞出水后仍继续下降(P<0.05,P<0.01),与B组比较有显著差异(P<0.05,P<0.01);B组犬腹部致伤前后其肺动脉楔压、中心静脉压、心输出量、心脏指数无明显差异;致伤后A组犬血肾素、脑钠肽水平明显升高(P<0.05,P<0.01),B组犬血肾素、脑钠肽水平无明显变化。结论:腹部开放伤合并海水浸泡致犬急性心力衰竭病理生理变化非常明显,为后续研究奠定了基础。

Objective：To observe the pathophysiological changes of dogs with open abdominal injury and seawater immersion-induced acute heart failure.Methods：Adult mongrel dogs were randomly divided into open abdominal injury＋seawater immersion group（group A,n=8） and simple open abdominal injury group（group B,n=8）.The cardiac rhythm,heart rate,systolic pressure,diastolic pressure,mean arterial pressure,pulmonary wedge pressure,central venous pressure,cardiac output,heart index,rennin,B-type brain natriuretic peptide（BNP）,other relevant parameters and death rate were observed before and after open abdominal injury,during 2h seawater immersion,and at different time points after getting out of the water.The left ventiricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）,stroke volumes（SV）,and left ventricular ejection fraction（LVEF） were measured before and 4 h after injury by ultrasonic cardiogram.Results：The mean arterial pressure decreased significantly in group A from 5 min after injury to the end of the ovservation（P〈0.05,P〈0.01）,and that of group B had no measurable changes.The pulmonary capillary wedge pressure（PAWP） increased significantly;the central venous pressure,cardiac output,and cardiac index decreased gradually,and continued to decrease after putting out of water,which were significantly different from those of group B（P〈0.05,P〈0.01）.Group B had no measurable changes in PAWP,central venous pressure,cardiac output,and cardiac index before and after abdominal injury.The blood rennin and BNP levels were significantly increased in group A（P〈0.05,P〈0.01）and had no significant changes in group B.Conclusion：Prominent pathophysiological changes occur in rats with open abdominal injury and seawater immersion-induced acute heart failure.