脓毒症小鼠死亡高发期腹腔脏器血流动力学观察

Hemodynamic changes of abdominal organs in the early stage of septic mice induced by cecal ligation and puncture

目的:研究脓毒症小鼠死亡高发期腹腔脏器血流动力学的变化。方法:应用高分辨小动物超声成像系统对正常雄性昆明小鼠先行心脏收缩功能和血流动力学指标的超声检测(0h)后,行盲肠结扎穿孔术(CLP)。术后分5个时点(12h、24h、36h、48h、60h)对小鼠进行相应超声指标检查。每只小鼠均进行编号,以便对小鼠进行连续性的观测,7d仍存活的小鼠视为存活动物。结果:CLP小鼠在脓毒症死亡高发期心输出量(CO)大致保持在正常水平或高动力学状态。左心收缩功能出现明显的代偿性改变。腹主动脉血流量的变化表现为先升高后降低,其阻力指数(RI)和搏动指数(PI)从24h开始出现明显升高。右侧肾动脉的血流量从12h开始便出现明显的下降,直到60h仍明显低于正常,其RI和PI变化不明显。门静脉血流量12h明显升高,24h明显下降,其后血流量与0h相比未见显著差异。充血指数从12h即明显升高,其后维持在高于正常的水平。结论:脓毒症小鼠腹腔各脏器在死亡高发期发生血流动力学的特征性变化。研究这些变化有助于阐明脓毒症的发病机制。

AIM：To characterize the hemoperfusion of abdominal organs in the early stage of sepsis in mice. METHODS：Health male Kunming mice were used in the study（n=100）.The techniques of 2D,M-mode and pulse-wave Doppler were applied to evaluate the systolic functions of the heart and the blood flow of abdominal aorta,right renal artery and portal vein before cecal ligation and puncture（CLP）as the baseline and at the time points of 12 h,24 h,36 h, 48 h and 60 h after CLP.The mice survived for 7 d were considered as survivals.All data were compared with the baseline values.RESULTS：The cardiac output of the CLP mice remained in normal or hyperdynamic levels in the early stage of sepsis.Compensatory responses of systolic functions were observed.The levels of blood flow in abdominal aorta were increased first and then decreased.Resistent index（RI）and pulsatility index（PI）of abdominal aorta began to increase at the time point of 24 h.Blood flow of right renal artery showed a significant decline from the beginning to the end of our observation. No significant difference of the right arteriorenal RI and PI was observed.Portal venous flow increased significandy at 12 h,and decreased at 24 h after CLP.Congestion index of the portal vein was distinctly increased from 12 h to the end of the observation.CONCLUSION：The hemodynamics of abdominal organs in early stage of septic mice shows specific changes,indicating an important role in evaluating the mechanism of sepsis.