L-精氨酸在创伤性休克治疗中的作用

Therapeutic effect of L-arginine on traumatic shock in rats

目的探讨外源性L-精氨酸(L-Arg)在创伤性休克治疗中的作用与机制。方法建立创伤性休克动物模型,随机分为休克组和处理组,于创伤前、休克末、复苏后1、3、5 h股动脉取血检测内皮素,并于相应时间点测定组织氧分压,监测血液动力学变化并记录存活时间。结果两组大鼠休克末及复苏后各时间点血浆内皮素浓度及组织氧分压较伤前有显著性差异(P<0.05),复苏后组织氧分压不能恢复到伤前水平,处理组于复苏后5 h血浆内皮素浓度显著低于休克组(P<0.05),复苏后肝脏、小肠的组织氧分压较休克组升高并有显著性差异(P<0.05)。处理组大鼠12、24 h存活率同休克组相比均有显著性差异。结论外源性L-Arg可降低血浆内皮素浓度,改善内脏器官的组织氧分压,并能明显提高休克模型的存活率。

Objective To evaluate the therapeutic effect of L-arginine (L-Arg) on traumatic shock in rats and explore the possible mechanisms. Methods Rat models of traumatic shock were established in Sprague-Daulay rats, which were randomly divided into two groups either to receive L-Arg treatment or not. The plasma concentration of endothelin (ET) and oxygen partial pressure in the tissues from the skeletal muscles, liver and small intestine were measured before and after the shock and 1, 3, and 5 h after resuscitation. The hemodynamics of the rats and their survival rates at 12 and 24 h were recorded. Results The changes of plasma ET levels and oxygen partial pressure in tissues of both groups were statistically significant after traumatic shock (P<0.05). Plasma ET concentration at 5 h after resuscitation was significantly lower in the treatment group than in the non-treatment shock group (P<0.05), while oxygen partial pressure in the liver and small intestine after resuscitation were significantly higher in the treatment group (P<0.05). The survival rates at 12 and 24 h were also significantly different between the 2 groups. Conclusion Adscititious L-Arg can decrease plasma ET levels, improve oxygen partial pressure of internal organs and significantly increase the survival rate of the rats with traumatic shock.