创伤性休克大鼠血浆内皮素与组织氧分压变化的实验研究

STUDY ON DYNAMIC CHANGES IN PLASMA ENDOTHELIN CONTENT AND TISSUE OXYGEN PARTIAL PRESSURE IN RATS WITH TRAUMATIC SHOCK

观察创伤性休克过程中血浆内皮素与组织氧分压的动态变化 ,探讨内皮素在创伤性休克过程中的意义。采用后肢创伤法建立创伤性休克大鼠模型 ,观察创伤前后血浆内皮素、动脉血气分析及骨骼肌、肝脏、小肠的组织氧分压的动态变化 ,监测血流动力学变化并记录存活时间。结果显示 ,创伤休克后血浆内皮素浓度迅速升高 ,显著高于伤前水平 ,复苏 7h浓度达到伤前水平的 2 5倍左右 ;休克后动脉血气各项指标及组织氧分压较创伤前有显著性差异 ,休克后出现失代偿性酸中毒 ,肝脏及小肠的氧分压变化较骨骼肌更为显著。提示创伤性休克后血浆内皮素显著升高 ,在早期对于维持血压有重要意义 ,但在休克后期可能是造成死亡的重要原因 ;内脏器官氧分压的不可逆性降低 ,可能是休克后期不易复苏的关键因素。

To study the role of endothelin(ET) in the pathogenesis of traumatic shock. Multiple injuries involving the leg bones, the soft tissue and hemorrhage in Sprague Daulay rat were produced by smashing its legs on both sides to induce traumatic shock. Dynamic changes in plasma ET, arterial blood gas analysis (ABGA) and oxygen partial pressure in tissues including skeletal muscles,liver and small intestine were detected at pre trauma and post shock periods. Meanwhile, hemodynamic parametars of the rats and their survival time were monitored and recorded. The data showed that plasma ET levels increased significantly after traumatic shock, reaching a peak of about 2 5 times of normal levels. There was statistically significant difference of ABGA values and tissues oxygen partial pressure between pre trauma and post shock periods. Metabolic acidosis appeared during traumatic shock. The changes in oxygen partial pressure in liver and small intestine were more significant than that of skeletal muscles. The data suggested that the significant increase in plasma ET contents after traumatic shock, might plays an important role in maintaining the blood pressure in the earty stage of shock, but might be an important cause of death in the late stage. The irreversible decrease in oxygen partial pressure in internal organs might be the key factor of refractoriness to resuscitation in an late stage of shock