摘要
目的 观察鸟苷酸环化酶抑制药亚甲蓝 (MB)对感染性休克犬血液动力学和氧合功能的影响。方法 采用内毒素静脉注入诱导的 1 1只感染性休克犬模型 ,输注 0 9%的氯化钠后 ,MB2mg/kg1 5分钟内静脉注入。经右颈内静脉放置的肺动脉导管测定基础、休克 1小时、输注生理盐水后和MB注入后 30、60、1 2 0、1 80分钟血液动力学 ,分析动脉、混合静脉血气和动脉血乳酸 ,计算氧合。结果 MB注入明显增加感染性休克犬平均动脉压 (MAP)、体血管阻力 (SVR)和左心室作功(LVSW) ,不影响肺动脉压 (PAP)、肺动脉嵌顿压 (PAOP)、心输出量 (CO)、氧输送 (DO2 )和氧摄取(VO2 ) (P >0 0 5)。MAP、SVR和LVSW的增高以 30分钟最为明显 ,分别从 (96 4± 1 6 6)mmHg、(4332 5± 75 8)dyne .sec .cm- 5、(1 4 0± 1 8) g .m升高到 (1 2 9 9± 1 8 3)mmHg、(52 67 1± 94 6)dyne.sec .cm- 5、(1 7 1± 2 6)g .m(P <0 0 1 ) ,1 80分钟基本回复。内毒素注入增加动脉血乳酸 (P <0 0 5) ;MB注入降低乳酸 ,1 2 0分钟最明显 ,从 (4 3± 1 3)mmol/L下降到 (3 4± 1 2 )mmol/L(P <0 0 5)。结论 MB注入改善感染性休克血液动力学 ,降低血乳酸 。
Objective To study the effects of methylene blue(MB),a guanylate cyclase inhibitor,on hemodynamics and oxygenation in dog with septic shock.Methods A model of septic shock was estabilished by infusion Escherichia coli endotoxin in eleven dogs.Normal saline for resuscitation and then 2mg/kg MB was intravened in 15min.Hemodynamics was measured at baseline,shocked for 1h and 30,60,120,180min after MB injection by Swan Ganz catheter.Blood gas and lactate was expired,then oxygenation was calculated.Results Mean arterial pressure(MAP),systemic vascular resistance(SVR) and left ventricular stroke work(LVSW) was significantly increased after the infusion of MB.Pulmonary arterial pressure(PAP),pulmonary arterial occlusion pressure(PAOP),cardiac output(CO),oxygen delivery (DO 2) and oxygen uptake(VO 2) was not significantly affected( P> 0 05).MAP,SVR and LVSW was respectively increased from (96 4±16 6)mmHg,(4332 5±75 8)dyne.sec.cm -5 and (14 0±1 8)g.m to (129 9±18 3)mmHg, (5*#267 1 ±94 6)dyne.sec.cm -5 and (17 1±2 6)g.m at 30min( P< 0 01).They returned to the baseline of an infusion of MB at 180min.Endotoxin administ ation was followed by a progressive increase in arterial lactate.MB injection can significantly decrease lactate from (4 3±1 3)mmol/L to (3 4±1 2)mmol/L( P< 0 05) at 120min.Conclusion MB can improve hemodynamics and decrease lactate without any change in oxygenation in septic shock dogs.
出处
《江苏医药》
CAS
CSCD
北大核心
2003年第2期110-112,共3页
Jiangsu Medical Journal
