机械通气联合盐酸戊乙奎醚对油酸诱导ARDS大鼠左心功能的影响

Effects of Mechanical Ventilation Combined With Penehyclidine Hydrochloride on Cardiac Functionof Acute Respiratory Distress Syndrome Rats

目的观察机械通气联合甲基戊乙奎醚(PHCD)对急性呼吸窘迫综合征(ARDS)大鼠心功能的影响。方法取雄性SD大鼠90只,按数字随机法分成5组,每组18只,各组又按造模成功后1h、2h和4h分为3个亚组(n=6):①假手术NS对照组(A组);②ARDS未干预组(B组);③机械通气治疗组(C组);④PHCD治疗组(D组);⑤ARDS机械通气与PHCD联合治疗组(E组)。测定各组各时段分别测定各组各时段左心室舒张末期压力(LVEDP)、左心室内最大上升速率(+LVdp/dtmax)及左心室内最大下降速率(-LVdp/dtmax),分别在对应时间点上取动脉血用酶联免疫吸附法测定大鼠血清中脑钠素(BNP)水平。结果机械通气联合盐酸戊乙奎醚组及盐酸戊乙奎醚组大鼠LVEDP、±LVdp/dtmax、BNP与模型未干预组、正常对照组差异有统计学意义(P<0.05),机械通气组上述指标与模型未干预组差异无统计学意义(P>0.05),机械通气联合盐酸戊乙奎醚治疗对左心功能的保护作用优于单纯盐酸戊乙奎醚、机械通气治疗。结论 ARDS可致大鼠心功能降低;机械通气联合盐酸戊乙奎醚可明显改善ARDS大鼠的心功能,其作用优于单用盐酸戊乙奎醚,单纯机械通气对ARDS大鼠左心功能无明显保护作用。

Objective To observe the effect of mechanical ventilation combined with penehyclidine hydrochloride on heart function of the acute stage of acute respiratory distress syndrome （ ARDS） in rat, and investigate the protective effect and related mechanisms of PHCD on the heart function of rats and provide a valid scientific basis for clinical treatment. Methods Sprague-Dawley rats were randomly divided into five groups. Control Group （ n=18 ）：Group A （ only tracheal intubation）;Group B （ ARDS without intervention group）;Group C （ ARDS with mechanical ventilation treatment group）;Group D （ ARDS with PH-CD treatment group）; group E （ARDS with mechanical ventilation and PHCD combined treatment group）. Recording the maximum rising and falling rate of left intraventricular pressure （ ± LVdp/dt max ） , and left ventricular end-diastolic pressure （ LVEDP） at each time point after the modeling. The serum concentrations of brain natriuretic peptide （ BNP） were determined at the corresponding time points by Enzyme linked immunosorbent assay. Results At the same time points, compared with group A, in other groups, ± LVdp/dt were significantly decreased （P〈0. 05）, LVEDP and BNP were significantly increased （P〈0. 05）. In each subgroup of group C, compared with group B, the ± LVdp/dt max increased, the LVEDP was decreased, while all the indicators with no statistically significance （P〈0. 05）. In group D, ± LVdp/dtmax and BNP was significantly increased （P〈0. 05）, LVEDP was significantly reduced （P〈0. 05）. In group E, ± LVdp/dtmax and BNP was significantly increased （P〈0. 05）, LVEDP was significantly reduced （P〈0. 05）. Conclusion ARDS could induce myocardial damage, decrease cardiac function in rats;MV combined with PH-CD can improve ARDS rat heart function.