多沙普仑、多巴胺对失血性休克犬等容输血后血流动力学的影响

Hemodynamic effects of doxapram and dopamine on hemorrhagic shock after isometric blood transfusion in dog

目的：在实验犬中观察多沙普仑、多巴胺对失血性休克等容输血后血流动力学的影响，探索多涉普仑对失血性休克等容输血后血流动力学产生良性影响的作用机制。方法：实验犬分对照组、多沙普仑组和多巴胺组，每组5条。三组动物均于股动脉快速放血30ml/kg，造成严重失血性休克模型，30分钟后等容输血。多沙普仑组于输血后立即静脉注射多沙普仑2mg／kg，多巴胺组于输血后立即静脉输注多巴胺8ug/kg/min.采用Swan-Ganz漂浮导管及心脏电脑监护仪等手段分别于动物休克、等容输血前后测定血流动力学参数。结果：休克5分钟和30分钟，三组动物的MAP、CO、CI、SV、LVSW、LVSWI明显下降，SVR明显增高；等容输血后15分钟三组动物的上述参数均有所恢复，多沙普仑组和多巴胺组都恢复至休克前水平，两组之间差异也无统计学意义，但对照组则未能恢复。结论：多沙普仑对失血性休克等容输血后血流动力学的良性影响与多巴胺相似，其作用机制可能与多沙普仑刺激机体释放多巴胺有关。

Objective: To investigate the hemodynamic effects ofdoxapram and dopamine on the dogs suffering from hemorrhagic shock after isometric blood transfusion.Method: Experimental dogs were divided into doxapram group, dopamine group and control group(5 dogseach). All animal were bleded 30ml/kg from femoral artery; then isometric blood was transfused after 30 minutes. doxapram 2mg/kg or dopamine 8ug/kg/min were given IV to dogs respetively in doxapram and dopamine group immediately after isometric blood transfusion. Hemodynamic indexes were observed before and at 5th and 30th min after shock and at 105th after isometric blood transrusion. Results: MAP,CO, CI, SV, LVSW, LVSWI decreased greatly and SVR increasedmarkedly at 5th and 30th min after shock in all 3 groups. All parameters of doxapram group and dopamine group returned to the basic levels at 15th min after isometric blood transfusion and no statistically signifi cant difference was found between two groups, while in control group were still lower than the basic levels, but SVR increased greatly. Conclusions: Both doxapram and dopamine can improe hemodynamic status of nemorrhagic shock after isometric blood transfusion, the mechanism by which doxapram improves the hedynamic status of hemorrhagic shock after isometric blood transfusion may be that doxapram stimulates body release of dopamine.