CAJ | 학술논문

目的探讨血液滤过(hemofiltration,HF)对重症中暑休克犬内皮素(endothelin,ET)和一氧化氮(nitric oxide,NO)的影响.方法 16只健康雄性杂种犬,随机分为中暑对照组(HS组)和血液滤过组(HF组)各8只.采用整体高温来诱导犬重症中暑休克,模型成功后立即出舱,HS组置于常温下观察,HF组立即行HF治疗,观察两组犬各时间点血浆ET和血清NO含量及NO/ET值的变化.结果两组犬中暑前ET和NO含量及NO/ET值比较无统计学差异(P＞0.05).中暑休克时ET和NO含量及NO/ET值较中暑前明显升高(P＜0.01),且两组之间比较无统计学差异(P＞0.05).休克后1 h:HS组ET值上升,HF组ET值下降,与休克时比较均无统计学意义(P＞0.05),但HF组ET明显低于HS组(P＜0.05)；HS组NO值升高,但无统计学意义,HF组NO值下降,低于休克时(P＜0.05),HF组NO明显低于HS组(P＜0.01)；HS组NO/ET值略降低,HF组NO/ET值亦下降,但均无统计学意义(P＞0.05),两组之间NO/ET比较亦无统计学意义(P＞0.05)；休克后2h和3h:HS组ET值继续上升明显高于休克时(P＜0.01),HF组ET值逐渐下降明显低于休克时(P＜0.01),HF组ET值明显低于HS组(P ＜0.01)；HS组NO值继续上升,但与休克时比较无统计学意义(P＞0.05),HF组NO逐渐下降,明显低于休克时(P＜0.01),HF组NO明显低于HS组(P＜0.01)；HS组NO/ET略低于休克时,但无统计学意义(P＞0.05),HF组NO/ET值明显低于休克时(P＜0.01),HF组NO/ET值明显低于HS组(P＜0.01).结论重症中暑休克犬会出现血浆ET和血清NO的升高及NO/ET值的失调,HF可清除血中异常升高的ET和NO,并恢复NO/ET值,而清除NO和ET可能是HF治疗重症中暑时稳定其血压和改善微循环灌注的重要机制之一.
목적 탐토혈액려과(hemofiltration,HF)대중증중서휴극견내피소(endothelin,ET)화일양화담(nitric oxide,NO)적영향.방법 16지건강웅성잡충견,수궤분위중서대조조(HS조)화혈액려과조(HF조)각8지.채용정체고온래유도견중증중서휴극,모형성공후립즉출창,HS조치우상온하관찰,HF조립즉행HF치료,관찰량조견각시간점혈장ET화혈청NO함량급NO/ET치적변화.결과 량조견중서전ET화NO함량급NO/ET치비교무통계학차이(P＞0.05).중서휴극시ET화NO함량급NO/ET치교중서전명현승고(P＜0.01),차량조지간비교무통계학차이(P＞0.05).휴극후1 h:HS조ET치상승,HF조ET치하강,여휴극시비교균무통계학의의(P＞0.05),단HF조ET명현저우HS조(P＜0.05)；HS조NO치승고,단무통계학의의,HF조NO치하강,저우휴극시(P＜0.05),HF조NO명현저우HS조(P＜0.01)；HS조NO/ET치략강저,HF조NO/ET치역하강,단균무통계학의의(P＞0.05),량조지간NO/ET비교역무통계학의의(P＞0.05)；휴극후2h화3h:HS조ET치계속상승명현고우휴극시(P＜0.01),HF조ET치축점하강명현저우휴극시(P＜0.01),HF조ET치명현저우HS조(P ＜0.01)；HS조NO치계속상승,단여휴극시비교무통계학의의(P＞0.05),HF조NO축점하강,명현저우휴극시(P＜0.01),HF조NO명현저우HS조(P＜0.01)；HS조NO/ET략저우휴극시,단무통계학의의(P＞0.05),HF조NO/ET치명현저우휴극시(P＜0.01),HF조NO/ET치명현저우HS조(P＜0.01).결론 중증중서휴극견회출현혈장ET화혈청NO적승고급NO/ET치적실조,HF가청제혈중이상승고적ET화NO,병회복NO/ET치,이청제NO화ET가능시HF치료중증중서시은정기혈압화개선미순배관주적중요궤제지일.
Objective To explore the effects of hemofiltration on endothelin and nitric oxide in severe heat stroke dogs with shock.Methods Sixteen healthy male hybrid dogs were randomly divided into 2 groups,8 for each:as heat stroke group( HS group)and hemofiltration group( HF group).Severe heat stroke model was induced with high temperature.The dogs were taken out of the heating cabin as soon as it reached heat stroke level,then observed under normal temperature with no treatment.The HF group accepted hemofiltration treatment immediately.The changes of ET,NO,NO/ET of two groups of dogs were observed and compared.Results The value of the ET,NO,NO/ET were compared,there were no significant differences (P ＞ 0.05 ) between two groups before heatstroke.The value of ET,NO,NO/ET of the dogs were all higher when got heat stroke and the two groups of dogs showed no significant difference(P ＞ 0.05 ).One hour after heat stroke,the ET of HS group rose continually while HF group declined,but there were no difference comparing with the time of got heat stroke.The value of ET in HF group was lower than HS group(P ＜0.05).The NO of HS group rose but showed no significant difference(P ＞0.05),while in HF group the NO declined and showed significant difference(P ＜ 0.01 ).The value of NO in HF group was lower than HS group(P ＜ 0.01 ).The ratio of NO/ET in HS group and HF group all declined and showed no significant difference ( P ＞0.05).There was no significant difference in NO/ET between two groups at this time(P ＞ 0.05).After two and three hours,comparing with the time of got heat stroke,the value of ET in HS group rose apparently and showed significant difference(P ＜0.01 ),the value of ET in HF group slowly declined and showed significant difference( P ＜ 0.01 ).The value of ET in HF group was obviously lower than HS group(P ＜0.01 ).The value of NO in HS group still rose but showed no difference ( P ＞ 0.05 ),the value of NO in HF group continuously declined and showed significant difference(P ＜0.01 ).The value of NO in HF group was lower than HS group(P ＜0.01 ).The ratio of NO/ET in HS group was little lower comparing with the time of got heat stroke,but showed no significant difference(P ＞ 0.05).The ratio of NO/ET in HF group declined and showed significant difference( P ＜ 0.01 ) and apparently lower than HS group( P ＜0.01 ).Conclusions The value of plasma ET and serum NO will rise and the balance of NO/ET will be disturbed in dogs with severe heat stroke caused shock,hemofiltration can remove the ET and NO from blood,and renew the ratio of NO/ET,so the clearance of ET and NO from blood by HF may be one of the important mechanism in stabilizing the blood pressure and improving circumfusion in dogs with severe heat stroke.