摘要
目的:探讨丙酮酸乙酯(EP)对内毒素诱导脓毒症休克犬急性肺损伤的影响。方法:健康雄性杂种犬20只,内毒素的主要活性成分脂多糖(LPS)静脉注射复制脓毒症休克模型,随机分为对照组(n=8)和EP治疗组(n=12)。对照组只接受林格氏液复苏。EP治疗组另外给予丙酮酸乙酯首剂0.05g/kg,然后0.05g.kg-1.h-1持续泵入。休克模型建立前及建立后0h、4h、8h、12h监测血气分析及呼吸力学指标,包括肺动态顺应性(Cdyn)、肺总顺应性(Ctot)、吸气相气道阻力(Rawi)、吸气峰压(PIP)、呼吸功(WOBvt),并用ELISA方法检测血浆肿瘤坏死因子TNF-α、白介素IL-6、白介素IL-10水平。结果:内毒素诱导建立脓毒症休克犬模型后,血气分析及呼吸力学改变符合急性肺损伤。氧合指数(OI)、HCO3-、pH下降,PaCO2上升(与模型前比较,休克后4hP<0.05)。肺动态顺应性和肺总顺应性下降,吸气峰压、气道阻力、呼吸功增加(与模型前比较,休克后8hP<0.05)。与EP治疗组比较,对照组改变更加明显,休克后8h动脉血气各项指标组间比较有显著差异(P<0.05)。丙酮酸乙酯虽未能改善脓毒症休克犬的呼吸力学指标,但能阻止呼吸力学参数的进一步恶化,休克后12h组间差异显著(P<0.05)。丙酮酸乙酯可以降低血浆中TNF-α、IL-6水平,提高IL-10水平,休克8h组间差异显著(P<0.05)。结论:丙酮酸乙酯可以对抗内毒素诱导的脓毒症休克犬的急性肺损伤。
AIM： To investigate the effect of ethyl pyruvate （EP） on acute lung injury in dogs with septic shock. METHODS： Twenty dogs with septic shock induced by lipopolysaccharide （LPS） were randomly divided into two groups： dog received placebo （Ringer＇s solution; control group, n = 8 ） or ethyl pyruvate in lactated Ringer＇s solution （0. 05 g/kg loading dose over 10 min, thereafter 0.05 g · kg^-1 ·h^-1 for 12 h; EP treatment group, n=12）. The parameters of respiratory me hanics, including lung dynamic compliance （Cdyn）, lung total compliance （Ctot）, inspiratory airway resistance （Rawi） , peak inspiratory pressure （PIP）, work of breathing （WOB）, and arterial blood gases were monitored every 4 h after basic measurements （ pre - LPS）. The contents of TNF - α, IL - 6 and IL - 10 in serum were also detected by ELISA and compared between two groups. RESULTS： The changes of respiratory mechanics and arterial blood gases were in line with acute lung injury after septic shock induced by LPS. Oxygen index （OI）, HCO3^-and pH dropped 4 h after septic shock. On the contrary, PCO2 elevated significantly compared with that of septic shock before （ P 〈 0. 05 ）. Cdyn, Ctot decreased and Rawi, PIP, WOB increased significantly 8 h after septic shock （ P 〈 0. 05）. The changes in parameters of respiratory mechanics and arterial blood gases in control group were more distinguished than those in EP treatment group. There were significantly differences between two groups 8 h after 3eptic shock （P 〈 0.05）. Although the significant improvement of respiratory mechanics was not observed, EP did prevent the parameters from worsening further more. Significantly differences between the two groups 12 h after septic shock （P 〈 0. 05 ） were found. Ethyl pyruvate also regulated the network of cytokines： increased the level of TNF-α, IL- 6 and reduced the content of IL- 10 in serum sig-nificantly compared with control group （ P 〈 0.05 ）. CONCLUSION ： Ethyl pyruvat
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2009年第3期547-550,共4页
Chinese Journal of Pathophysiology
