摘要
目的对比观察不同剂量依托咪酯持续输注对失血性休克犬血清TNF-α、IL-6及IL-10含量的影响。方法健康成年雄性犬24只,体重12~14 kg,随机分为4组,每组6只。即:C组、对照组,S组、休克组,E1组、依托咪酯10μg/(kg·min)持续输注,E2组依托咪酯20μg/(kg·min)持续输注。4组犬基础麻醉后行气管插管,右侧股动脉、股静脉及左侧股动脉穿刺置管,全身肝素化。C组不作任何处理;S组、E1组和E2组在气管插管后建立失血性休克模型,平均动脉压(MAP)维持在40~50 mm Hg,E1和E2组在犬休克后分别持续输注依托咪酯10和20μg/(kg·min)1 h,然后回输血液进行复苏观察2 h。各组每30 min追加维库溴铵(0.05 mg/kg),脑电双屏指数(BIS)维持在40-60。观察并记录休克前(T0)、休克1 h(T1)、复苏1 h(T2)及复苏2 h(T3)的MAP、中心静脉压(CVP)、心率(HR)、BIS、Sp O2和PETCO2,并抽取相应时间静脉血进行离心,采用放射免疫分析法测定血清TNF-α、IL-6及IL-10的含量。结果 C组各时间犬血清TNF-α、IL-6及IL-10含量比较差异无统计学意义(P〉0.05);S组、E1组和E2组在T1时的血清IL-6、TNF-α含量升高(P〈0.05),IL-10含量无明显变化(P〉0.05);与S组比较,E1组各时间TNF-α、IL-6及IL-10含量无明显变化(P〉0.05),而E2组在T1时的血清TNF-α、IL-6含量显著下降(P〈0.01),IL-10含量亦降低(P〈0.05)。结论依托咪酯持续输注对失血性休克犬血清IL-6、TNF-α有抑制作用,20μg/(kg·min)依托咪酯持续输注对TNF-α、IL-6及IL-10抑制作用更明显。
[Objective] To study the infuence of continuous infusion of etomidate of different doses on TNF-α, IL-6 and IL-10 in dogs with hemorrhagic shock. [Methods] Twenty-four healthy adult male dogs weighing 12-14 kg were randomly divided into four group with 6 in each group: group C (control group), group S (shock group), group E1 [10 μg /(kg.min) etomidate continuous infusion] and group E2 [20 μg/(kg. min) etomidate continuous infusion]. The dogs also had basical anesthesia with 2.5% sodium pentobarbitone (25 mg/kg) and endotracheal intubation with veeuronium (0.1 mg/kg). All were cathetered in femoral artery and femoral vein and totally heparinized. MAP, CVP, HR, PETCO2, SpO2 and BIS were continuous monitored. The group C did not receive any treatment. In the experimental groups the model of hemorrhagic shock was built and MAP wear maintained between 40-50 mmHg, while the dogs in the groups El and E2 had continuous etomidate infusion for 1 h and then the blood reinfusion for recovery, and were observed for 2 h. In all the groups vecuronium (0.05 mg/kg) were added every 30 minutes to maintain muscle relaxation. Radioimmunoas say was used to decect the content of serum IL-6, IL-10 and TNF-α before hemorrhagic shock (T0), 1 h after shock (T1), 1 h after resuscitation (T2) and 2 h after resuscitation (T3). [Results] In the group C no statistically significant differences were found in IL-6, TNF-α or IL-10 between different time points (P〉 0.05). Compared with the group C, the concentrations of IL-6 and TNF-α in the groups S, E1 and E2 at T1 were increased (P〈 0.01), that of IL-10 did not change (P〉 0.05). Compared with the group S, there were no differences in the levels of IL-6, TNF-α IL-10 in the group E1 (P〉0.05), but the levels of IL-6 and TNF-α in the group E2 were decreased with statistical differences (P 〈 0.01), and the level of IL-10 was also decreased in the group E2 (P 〈 0.05). [Conclusion] Continuous etomidate infusion m
出处
《中国现代医学杂志》
CAS
北大核心
2015年第20期50-53,共4页
China Journal of Modern Medicine
基金
贵州省科技厅基金(No:20112263)
关键词
依托咪酯
失血性休克
炎症因子
etomidate
hemorrhagic shock
inflammatory factor