依托咪酯持续输注对失血性休克犬炎症因子的影响

发布时间：2018-04-24 21:54

本文选题：依托咪酯 + 失血性休克　；参考：《中国现代医学杂志》2015年20期

【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(P0.05);S组、E1组和E2组在T1时的血清IL-6、TNF-α含量升高(P0.05),IL-10含量无明显变化(P0.05);与S组比较,E1组各时间TNF-α、IL-6及IL-10含量无明显变化(P0.05),而E2组在T1时的血清TNF-α、IL-6含量显著下降(P0.01),IL-10含量亦降低(P0.05)。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。
[Abstract]:Objective to observe the effects of continuous infusion of etomidate on serum TNF- 伪 -IL-6 and IL-10 in dogs with hemorrhagic shock. Methods 24 healthy adult male dogs, weighing 12 ~ 14 kg, were randomly divided into 4 groups, 6 in each group. That is, group C, group S, shock group, group E1, etomidate group (10 渭 g/(kg / min)) continuous infusion of etomidate 20 渭 g/(kg / min) after basic anesthesia, endotracheal intubation was performed, right femoral artery, femoral vein and left femoral artery were inserted into the right femoral artery, femoral vein and left femoral artery. The hemorrhagic shock model was established after tracheal intubation in group E _ 1 and E _ 2 without any treatment. The mean arterial pressure (MAPP) was maintained at 405mm HgN E1 and E2 groups after shock, etomidate was continuously infused for 10 and 20 渭 g/(kg min)1 / h, and then resuscitation was observed for 2 hours. Every 30 min each group added vecuronium bromide 0.05 mg 路kg ~ (-1), and the BIS (double screen index) of EEG was maintained at 40 ~ 60 mg 路kg ~ (-1) 路kg ~ (-1) 路min ~ (-1). The mitogen (MAPP), central venous pressure (CVP), heart rate (HRT) BIS-SpO2 and PETCO2 were observed and recorded before shock, 1 hour after shock, 1 hour after shock, 1 hour after resuscitation, 1 h after resuscitation and 2 h after resuscitation. The concentrations of TNF- 伪 6 and IL-10 in serum were determined by radioimmunoassay. Results there was no significant difference in serum TNF- 伪 IL-6 and IL-10 levels between group C and group C. There was no significant difference in serum levels of IL-6 and TNF- 伪 between E1 group and E2 group at T1. There was no significant change in serum TNF- 伪 -IL-6 and IL-10 levels in E _ 1 group and E _ 2 group at T _ 1, and there was no significant difference in IL-10 and TNF- 伪 IL-6 in E _ 1 group compared with S group. The level of serum TNF- 伪 and IL-6 decreased significantly in E2 group at T1, and the content of IL-10 in P0.01 was also decreased in E2 group. Conclusion continuous infusion of etomidate has an inhibitory effect on serum IL-6 TNF- 伪 in hemorrhagic shock dogs (20 渭 g/(kg / min). Etomidate continuous infusion has more obvious inhibitory effects on TNF- 伪 IL-6 and IL-10.
【作者单位】：遵义医学院附属医院麻醉科;
【基金】：贵州省科技厅基金(No:20112263)
【分类号】：R614

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