纳洛酮对创伤性休克大鼠血一氧化氮、内皮素的影响

EFFECT OF NALOXONE ON NITRIC OXIDE AND ENDOTHELIN DURING TRAUMATIC SHOCK IN RATS

探讨纳洛酮 (NAL)在创伤性休克治疗中的作用与机制。建立创伤性休克动物模型 ,根据复苏时是否应用NAL随机分为休克对照组和NAL处理组 ,于创伤前、休克末及复苏后 1、3、5h检测β 内啡肽、一氧化氮、内皮素 ,并于相应时间点测定组织氧分压 ,监测血流动力学变化并记录存活时间。结果显示 ,休克对照组大鼠休克末及复苏后各时间点血β 内啡肽、一氧化氮、内皮素浓度及组织氧分压和伤前比较差异有统计学意义(P <0 0 5 ) ,复苏后组织氧分压不能恢复到伤前水平 ;NAL处理组复苏后各时间点β 内啡肽、内皮素、一氧化氮浓度显著低于休克对照组(P <0 0 5 ) ,复苏后肝脏、小肠的组织氧分压较休克对照组升高 (P <0 0 5 )。处理组大鼠 12、2 4h存活率同休克对照组比较差异均有统计学意义。结果表明 ,NAL可降低循环血β 内啡肽、内皮素、一氧化氮浓度 ,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。

The purpose of this study was to evaluate the effect and mechanism of naloxone(NAL)in the treatment of traumatic shock. A traumatic shock animal model in Sprague-Dawley rats was reproduced, and the animals were randomly divided into two groups with respect to treatment or non-treatment with NAL. Plasma β-endorphin(β-EP), nitric oxide(NO)and endothelin(ET) levels and oxygen partial pressure in tissues, including skeletal muscles, liver and small intestine, were determined before trauma,after traumatic shock, and 1h, 3h, and 5h after resuscitation. Meanwhile, hemodynamic parameters of the rats and their survival rates at 12h and 24h were monitored and recorded. The data showed that changes in plasma β-EP, NO, ET levels and oxygen partial pressure in tissues of the two groups were statiscally significantly different between pre-trauma and post-shock periods(P<0.05). Plasma β-EP, NO, ET levels were significantly lower in animals receiving NAL treatment compared with shock group(P<0.05), while oxygen partial pressure in the liver and small intestine after resuscitation were significantly higher than that of shock group(P<0.05). There were also statistically significant differences in 12h and 24h survival rates between the two groups. The results suggested that NAL could decrease plasma β-EP, NO and ET levels, improve oxygen partial pressure of internal organs, and increase the survival rate significantly in rats with traumatic shock.