维生素C对实验性高原出血性休克的治疗作用

Therapeutic effect of vitamin C on experimental high altitude hemorrhagic shock

目的：探讨氧自由基在高原出血性休克发生的作用及大量维生素Ｃ的抗休克作用。方法：１６只山羊减压至模拟４０００ｍ高原２４ｈ，然后放血引起休克，将动物分为对照组和维生素Ｃ治疗组。结果：（１）失血期注入少量生理盐水后休克进一步加重；相反，注入维生素Ｃ后，心指数、左室收缩压、ｄｐ／ｄｔｍａｘ、氧运送量、氧耗量和ｐＨ明显增加，而脂质过氧化物（ＬＰＯ）明显降低。（２）输血输液后，对照组仅短暂改善心血管功能，其后血压下降，动物存活时间仅７ｈ３８ｍｉｎ。而维生素Ｃ治疗组，较好保持心血管功能、ＬＰＯ含量正常，活存时间为２０ｈ９ｍｉｎ。结论：氧自由基可能在高原出血性休克发生中起着重要作用。

Abstract AIM:To observe the role of free radical in pathogenesis of high altitude hemorrhagic shock and the antishock effect of vitamin C. METHODS:Sixteen goats were expose to a simulated 4 000 m high altitude for 24 h and then shock was induced with bleeding.Goats were divided into 2 groups:the control group with saline and the treated group with vitamin C. RESULTS:(1)After administration of saline shock was exacerbated further,however after injection of vitamin C,blood pressure,cardiac index,dp/dt max,oxygen delivery,oxygen consumption and pH were augmented significantly ,but the level of LPO was reduced as compared with the control group.(2)After transfusion of the shed blood and saline,cardiac vascular function immediately improved and then blood pressure declined gradually,the mean surviving time was 7.3h in the control group.On the other hand,the cardiac vascular function and pH were maintained at normal level for sixteen hours,the mean surviving time was 20.9h in the group treated with vitamin C.CONCLUSION:Oxygen derived free radical may play an important role in pathogenesis of high altitude hemorrhagic shock and vitamin C may be used to treat high altitude hemorrhagic shock. MeSH Shock,hemorrhagic;Oxygen consumption;Ascorbic acid;Lipid peroxides