观察HSAD对高原大鼠失血性休克合并肺水肿的疗效

Benefical effect of HSAD on hemorrhagic shock with pulmonary edema at high altitude in rats

目的 探讨小剂量高渗氯化钠 /醋酸钠 /右旋糖酐 4 0 (5 %氯化钠 /3.5 %醋酸钠 /6 %右旋糖酐4 0 ,HSAD)溶液对初进高原大鼠失血性休克合并肺水肿的治疗作用。方法 初进高原 (西藏拉萨海拔 36 5 8米 )SD大鼠 71只 ,戊巴比妥钠腹腔麻醉 ,维持血压在 5 0mmHg(6 .6 7kPa) ,加油酸 (5 μl/1 0 0gwt,iv) 1小时 ,复制失血性休克合并肺水肿模型 (正常对照组不放血不给油酸 )。第一部分实验 35只大鼠随机分为 5组 (每组 7只 ) :正常对照组、单纯失血性休克组、失血性休克合并肺水肿组、平衡盐液治疗组、HSAD治疗组。观察治疗后 1 5、30、6 0分钟和 1 2 0分钟的血流动力学指标变化 ,以及 30分钟和 1 2 0分钟的血气指标变化以及 1 2 0分钟肺脑含水量变化。第二部分实验 36只大鼠 ,观察HSAD对失血性休克合并肺水肿大鼠存活时间的影响。结果HSAD(4ml/kg)可显著提升失血性休克合并肺水肿大鼠平均动脉压 ,改善其左室内压 (LVSP) ,左室内压最大变化速率 (±dp/dtmax)和动脉血气指标 ,降低肺脑含水量 ,明显延长动物存活时间 ;而等容量平衡盐液无明显疗效。结论 HSAD有较好的治疗高原失血性休克合并肺水肿的作用。

Objective To study the effects of hypertonic saline/sodium acetate/dextran(5%NaCl/3.5%NaAc/6%Dextran40,HSAD)on hemorrhagic shock with pulmonary edema in the rats at high altitude.Methods Seventy one SD rats,transported to LaSa,Tibet,3658 meters above the sea level,were anesthetized with sodium pentobarbital (30mg/kg·ip). Hemorrhagic shock model with pulmonary edema was induced by hemorrhage(50 mmHg) plus intravenous injection of oleic acid(5μl/100g wt) for 1 hour. Experiment was conducted in two parts. In part I,35 rats were equally divided into 5 groups(n=7 each group): normal control,hemorrhagic shock, hemorrhagic shock with pulmonary edema(HSPE),HSPE plus lactated Ringer's solution (LR, 4ml/kg) or HSAD(4ml/kg). Hemodynamic parameters including mean arterial blood pressure(MAP),left intraventricular systolic pressure (LVSP) and the maximal change rate of intraventricular pressure rise or decline (±dp/dt max) were observed at 15,30,60 and 120 min,blood gases were observed at 30 and 120 min,and the water content of lung and brain was determined at 120 min after drug administration. The effect of HSAD on survival time of hemorrhagic shock with pulmonary edema were observe in 36 rats of part Ⅱ.Results HSAD(4ml/kg)significantly increased MAP, LVSP and ±dp/dt max,improved the variables of blood gases and decreased the water content of lung and brain,and prolonged the survival time.Conclusion HSAD has a beneficial effect in the treatment of hemorrhagic shock with pulmonary edema at high altitude.