中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2009年
9期
544-547
,共4页
内毒素休克%多巴胺%肺动脉压
內毒素休剋%多巴胺%肺動脈壓
내독소휴극%다파알%폐동맥압
endotoxic shock%dopamine%pulmonary artery pressure
目的 通过观察多巴胺对内毒素休克犬肺动脉压力的影响,评价多巴胺用于内毒素休克治疗的临床意义.方法 选择健康雄性杂种犬20只,随机分为4组,每组5只.以静脉注射脂多糖(LPS)1 mg/kg制备内毒素休克模型,2 h后分别静脉泵人生理盐水5 ml/h(模型组)和多巴胺5、10、20 μg·kg-1·min-1(分别记为D5组、D10组、D20组).经股动、静脉及开胸行肺动脉穿刺测压,记录制模前、给药前及给药后5、10、30、60及120 min时平均动脉压(MAP)及平均肺动脉压(MPAP).结果 不同浓度多巴胺均能升高MPA和MPAP,与模型组比较差异均有统计学意义(P<0.05或P<0.01);且D10组和D20组MAP较D5组升高幅度大,D20组MPAP较D5组和D10组升高幅度大(P<0.05或P<0.01).给予多巴胺后120 min各组MAP/MPAP比值均高于模型组,以高剂量组显著(P均<0.05).结论 不同浓度的多巴胺均能在升高MAP的同时使肺循环阻力增加致肺动脉压力也升高,且体动脉压力升高幅度明显大于肺动脉压力.
目的 通過觀察多巴胺對內毒素休剋犬肺動脈壓力的影響,評價多巴胺用于內毒素休剋治療的臨床意義.方法 選擇健康雄性雜種犬20隻,隨機分為4組,每組5隻.以靜脈註射脂多糖(LPS)1 mg/kg製備內毒素休剋模型,2 h後分彆靜脈泵人生理鹽水5 ml/h(模型組)和多巴胺5、10、20 μg·kg-1·min-1(分彆記為D5組、D10組、D20組).經股動、靜脈及開胸行肺動脈穿刺測壓,記錄製模前、給藥前及給藥後5、10、30、60及120 min時平均動脈壓(MAP)及平均肺動脈壓(MPAP).結果 不同濃度多巴胺均能升高MPA和MPAP,與模型組比較差異均有統計學意義(P<0.05或P<0.01);且D10組和D20組MAP較D5組升高幅度大,D20組MPAP較D5組和D10組升高幅度大(P<0.05或P<0.01).給予多巴胺後120 min各組MAP/MPAP比值均高于模型組,以高劑量組顯著(P均<0.05).結論 不同濃度的多巴胺均能在升高MAP的同時使肺循環阻力增加緻肺動脈壓力也升高,且體動脈壓力升高幅度明顯大于肺動脈壓力.
목적 통과관찰다파알대내독소휴극견폐동맥압력적영향,평개다파알용우내독소휴극치료적림상의의.방법 선택건강웅성잡충견20지,수궤분위4조,매조5지.이정맥주사지다당(LPS)1 mg/kg제비내독소휴극모형,2 h후분별정맥빙인생리염수5 ml/h(모형조)화다파알5、10、20 μg·kg-1·min-1(분별기위D5조、D10조、D20조).경고동、정맥급개흉행폐동맥천자측압,기록제모전、급약전급급약후5、10、30、60급120 min시평균동맥압(MAP)급평균폐동맥압(MPAP).결과 불동농도다파알균능승고MPA화MPAP,여모형조비교차이균유통계학의의(P<0.05혹P<0.01);차D10조화D20조MAP교D5조승고폭도대,D20조MPAP교D5조화D10조승고폭도대(P<0.05혹P<0.01).급여다파알후120 min각조MAP/MPAP비치균고우모형조,이고제량조현저(P균<0.05).결론 불동농도적다파알균능재승고MAP적동시사폐순배조력증가치폐동맥압력야승고,차체동맥압력승고폭도명현대우폐동맥압력.
Objective To evaluate the values of dopamine in treating endotoxic shock by observing the changes in the pulmonary artery pressure (PAP) during the treatment. Methods Twenty healthy dogs were randomly divided into four groups with 5 in each group. Endotoxic model was reproduced by injecting lipopolysaccharides (LPS) 1 mg/kg intravenously. Two hours later, nomal saline (NS) 5 ml/h was intravenously given in model group, or dopamine 5, 10, 20 μg·kg-1·min-1 was given in D5 group, D10 group, D20 group intravenously. Femoral artery pressure, femoral vein pressure and PAP were measured, and mean arterial pressure (MAP) and mean pulmonary artery pressure (MPAP) were recorded at 0, 5, 10, 30, 60, 120 minutes after infusion of NS or dopamine. Results Compared with the model group, all different concentrations of dopamine could elevate MAP, MPAP (P<0.05 or P<0.01). Compared with D5 group, the percentage of elevation of MAP of D10 group and D20 group was greater, and the percentage of elevation of MPAP of D20 group was greater than that in D5 group and D10 group (P<0.05 or P<0.01). The ratio of MAP/MPAP in each dopamine group was higher than that of model group, and the increase was more marked in the groups of higher concentrations (all P<0.05). Conclusion MAP of endotoxic dog lowered obviously, while there was little change in PAP. After infusion ot dopamine intravenously, both MAP and PAP are elevated. The increase in resistance of pulmonary microeirculation is the main reason for the elevation of PAP.
