感染性休克患儿血乳酸分析

目的了解感染性休克患儿体内血乳酸的变化,与预后及多器官功能衰竭(MODS)的关系.方法感染性休克患儿35例及对照组35例,取动脉血作乳酸测定.结果休克组血乳酸值高于对照组(p<0.01),休克35例,MODS组28例,无MODS组7例,死亡10例,存活25例.MODS组血乳酸高于无MODS组(p<0.05),死亡组血乳酸高于存活组(p<0.01).结论感染性休克患儿体内血乳酸水平升高,血乳酸值越高,越容易出现MODS,预后越差.     

感染性休克患儿血乳酸分析

目的了解感染性休克患儿体内血乳酸的变化,与预后及多器官功能衰竭(MODS)的关系.方法感染性休克患儿35例及对照组35例,取动脉血作乳酸测定.结果休克组血乳酸值高于对照组(p<0.01),休克35例,MODS组28例,无MODS组7例,死亡10例,存活25例.MODS组血乳酸高于无MODS组(p<0.05),死亡组血乳酸高于存活组(p<0.01).结论感染性休克患儿体内血乳酸水平升高,血乳酸值越高,越容易出现MODS,预后越差.     

血乳酸和降钙素原与脓毒性休克的相关性研究

目的探讨血乳酸和降钙素原与脓毒性休克的相关性,为早期诊断脓毒性休克、评估病情严重程度、疗效及预后提供依据。方法选取30例脓毒性休克患者作为观察组,40例入住ICU的肺部感染患者作为对照组;于入院6h、24h及48h,检测所有患者的血乳酸和降钙素原浓度,并作统计学对比,分析血乳酸和降钙素原浓度的变化规律;在24h内,观察组患者进行APACHEII评分,对血乳酸和降钙素原浓度与APACHEII评分进行Pearson相关性分析。结果观察组入院6h、24h及48h,血乳酸浓度分别为8.54±2.17mmol/L、7.42±1.75mmol/L、6.59±1.14mmol/L;降钙素原浓度分别为5.47±1.25ng/m L、4.85±0.94ng/m L、3.52±0.76ng/m L。对照组入院6h、24h及48h,血乳酸浓度分别为2.58±1.12mmol/L、2.24±0.96mmol/L、2.05±0.78mmol/L;降钙素原浓度分别为13.52±3.14ng/m L、11.28±2.07ng/m L、8.65±1.75ng/m L。观察组和对照组患者在诊疗过程中,血乳酸和降钙素原浓度均呈下降趋势;观察组各时间点的血乳酸和降钙素原浓度均显著高于对照组,差异具有统计学意义(P<0.05)。观察组血乳酸和降钙素原浓度与APACHEII评分的Pearson相关性分析显示,血乳酸和降钙素原浓度与APACHEII评分呈正相关(P<0.05)。结论血乳酸和降钙素原可作为早期诊断脓毒性休克的生物学指标,与脓毒性休克的病情严重程度、疗效及预后具有相关性,血乳酸和降钙素原浓度越高,脓毒性休克病情越严重,预后越差。     

小鼠内毒素休克某些血液变化和细胞超微结构损伤的发生

小鼠内毒素休克有血液的乳酸、ＮＰＮ、ＡＫＰ、ＬＤＨ水平升高和ｐＨ值降低并可用６５４－２或ＡＬ所预防，只是预防ＮＰＮ升高的效应须在早期的肾血管挛缩消失后才能显示出来；心、肝、肠和肺的ＭＤＡ含量升高并可被６５４－２预防，除肺外还可被ＡＬ预防；将高肺ＭＤＡ只能用６５４－２预防结合注射内毒素后１０ｍｉｎ有ＷＢＣ入肺扣押来看，损伤肺的自由萁坷能主要来自被激活的中性粒细胞；血中ＡＫＰ和ＬＤＨ升高分别反映溶酶体     

严重烧伤休克病人血乳酸监测与组织氧合相关性的临床研究

目的探讨严重烧伤休克病人监测血乳酸 (BL)与组织氧合的相关性。方法早期收治的大面积烧伤病人34例 ,随机分为两组 ,改进组18例 ,采用改进后的休克复苏方案治疗 ,尿量维持于100ml/h左右 ;未改进组16例 ,常规复苏 (国内公式 ) ,尿量维持于40ml/h左右。两组同时于复苏前、复苏后1h、8h、16h、24h、48h、72h监测BL及传统监测指标 (尿量、心率 )。结果①烧伤休克乏氧代谢持续时间长 ,复苏时相应延长至72h ,且尿量应达100ml/h ,确保复苏达到终点。②复苏在传统监测指标 (心率、尿量 )指导下 ,治疗效果不佳 ,病死率高达31.2 % ;而改进组通过监测BL ,病死率仅为5.5 %。③有效的抗休克 ,组织器官缺血缺氧被纠正 ,随着BL值下降 ,患者的尿量逐渐增加 (两者呈负相关r= -0.91) ;同时心率逐渐减慢趋于正常 (两者呈正相关r=0.817)。结论严重烧伤休克时 ,组织器官灌注不足 ,组织的乏氧代谢增强 ,血BL可较准确地反映组织的氧合状况     

创伤性休克大鼠血浆中一氧化氮与P-选择素的变化

许多研究表明 ,一氧化氮 (nitricoxide ,NO)与P 选择素在感染、出血等过程中起重要作用 ,但在创伤性休克中它们的变化情况及相互关系尚未见报道。为此 ,我们复制大鼠模型对此进行了初步探讨。1　材料与方法1 1　动物模型复制 :健康Sprague Dawley大鼠 16只 ,体重(2 80± 2 0 )g ,雌雄兼有。随机分为对照组与创伤休克组 ,每组8只。 13 3%氨基甲酸乙酯 - 0 5 %氯醛糖 (0 6mL/ 10 0g)腹腔麻醉。 (行一侧颈总动脉插管 ,动脉插管外接三通 ,分别连接二道生理记录仪以供观察动脉血压 ,和连接注射器以供放血及补液。)休克组以特制台钳致大鼠双…     

创伤性休克的新概念

创伤性休克是临床常见的急症性危象,病情危重、进展快速、处置难度大。对其病理生理机制和临床救治的研究始终是医学研究的重点。本文就近年来在创伤性休克方面的新概念和新理念进行了分析和综合,旨在"抛砖引玉" ,促进我国的休克救治水平进一步提高。     

Changes in the fatty acid composition of lipids in the blood plasma and certain organs in traumatic shock

The fatty acid composition of the total lipids of the myocardium, lungs, liver, intestine, adipose tissue, and blood plasma was investigated in the course of development of traumatic shock produced in dogs by crushing the soft tissues of the thigh. The development of shock is accompanied by an increase in the relative percentage of linoleic and arachidonic acids in the blood plasma and certain organs; close correlation was found between the linoleic acid concentrations in the adipose tissue and blood. A deficiency of oleic acid also was observed in the lipids of the organs studied.Department of Pathological Physiology and Biological Chemistry, Rostov Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR A. N. Chernukh.) Translated from Byulleten Éksperimental'noi Biologii i Meditsiny, Vol. 85, No. 3, pp. 290–291, March, 1978.     

失血性休克家兔血浆中分子物质及血糖含量的动态变化

用改进的紫外吸收法及葡萄糖氧化酶法分别测定了家兔失血性休克前后不同时间动脉和静脉血浆中分子物质（ＭＭＳ）及血糖含量的动态变化。结果表明，在家兔失血性休克后３０ｍｉｎ，动、静脉血浆ＭＭＳ含量比休克前显著降低；血糖含量则显著升高。随着休克发展，ＭＭＳ含量逐渐回升，在动物临终前呈显著升高，并且静脉血浆含量显著高于动脉血浆含量，血糖浓度则随休克发展不断升高。输血组在休克３０ｍｉｎ后将血液回输，血压恢复，Ｍ     

血吸虫病兔肠系膜上动脉夹闭休克时内脏超氧化物歧化酶的变化

本实验在血吸虫病兔肠系膜上动脉夹闭休克(SMAO)模型上,测定内脏SOD活力(n=10),并与正常兔合并SMAO组(n=7)和假手术组(n=6)对照。旨在探讨自由基反应及肝脏在多器官功能衰竭(MOF)中的作用。病理检查提示,血吸虫病兔合并SMAO组内脏有明显损伤。SOD活力测定:血吸虫病兔与正常兔合并SMAO时内脏SOD明显低于假手术组(P<0.01)。血吸虫病兔合并SMAO组肝、肺、胃SOD明显低于正常兔合并SMAO组,分别为2541/2993、1235/1656、1072/1578,(P<0.01),肾无显著性差异(1500/1558)。本研究表明,自由基反应是休克并发MOF的原因之一,合并有血吸虫肝病时更易发生MOF。     

Energy metabolism in the rat brain in the course of traumatic shock

The concentration of high-energy phosphates (ATP, creatine phosphate), the total content of adenyl nucleotides, and the energy potential of the brain cells did not change significantly in experimental animals after trauma to the soft tissues of the thigh, until the terminal phase. The intensity of glycolysis was increased. In the terminal phase anaerobic processes predominated somewhat over aerobic. The absence of changes in the concentration of high-energy phosphates in the rat brain in traumatic shock is probably associated with centralization of the circulation and it is evidence that no critical exhaustion of energy takes place in the brain.I. I. Dzhanelidze Leningrad Emergency Aid Scientific-Research Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR V. S. Il'in.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 78, No. 11, pp. 27–29, November, 1974.     

失血性休克大鼠血管平滑肌收缩功能变化研究

目的：研究失血性休克后大鼠胸主动脉血管平滑肌收缩功能变化并初步探讨其可能机制。方法：采用生物张力换能器及生理记录仪等技术体外测定失血性休克大鼠在休克后2 h、4 h VSM环对去甲肾上腺素（NE）、苯肾上腺素（PE）、咖啡因（caffeine）及氯化钾（KCl）等的收缩反应张力。结果：VSM环在休克后2 h、4 h对NE的最大反应张力分别为对照组的76.17%和66.50%；休克2 h后对高浓度（大于20 mmol/L）K⁺ 和20 mmol/L caffeine的反应张力明显下降；休克后4 h对 3×10^-6 mol/L PE的反应张力亦显著下降。结论：失血性休克后大鼠VSM收缩功能下降，反应性降低，其初步机制可能部分与休克后VSM细胞胞外钙内流及胞内钙释放功能下降等有关。     

In a medium containing glucose, lactate carbon is incorporated by gonococci predominantly into fatty acids and glucose carbon incorporation is increased: implications regarding lactate stimulation of metabolism

The reason for stimulation by lactate of metabolism of gonococci growing in a medium containing glucose, which enhances pathogenicity by increasing growth rate, lipopolysaccharide (LPS) synthesis and protein formation, has been investigated. Tricine dodecylpolyacrylamide gel electrophoresis (SDS-PAGE) and thin layer chromatography (TLC) on homogenates of gonococci grown in this medium with [14C]lactate showed that lactate carbon was preferentially incorporated into lipid and LPS. Nuclear magnetic resonance (NMR) spectroscopy on lipid extracted from gonococci grown in the glucose containing medium with [13C]lactate showed that lactate carbon was incorporated into fatty acid moieties and not into ethanolamine or glycerol moieties. In contrast, NMR on lipid from gonococci grown with [13C]glucose indicated glucose carbon in both moieties. When unlabelled lactate was added, lipid synthesis from [l3C]glucose was stimulated and small amounts of different fatty acids were formed. The NMR data shows that gluconeogenesis from lactate carbon does not occur in the presence of glucose, suggesting that lactate is used solely for rapid production, via pyruvate, of acetyl CoA, the precursor not only for fatty acid synthesis but also for the constituents and products of the citric acid cycle, including ATP. The rapid formation of a high level of acetyl CoA is the probable reason for the stimulation of metabolism and oxygen uptake by lactate. 14C label on LPS was detected in its fatty acids. Most proteins that stained with silver in tricine SDS-PAGE were not significantly labelled by [14C]lactate in the glucose-containing medium. Two of three appreciably labelled proteins were identified by N-terminal sequencing as GroEL and porin 1B, and one of the two less labelled proteins was similar to peroxiredoxin type proteins. There were no signs of specific induction of these proteins by lactate and their labelling was consistent with fatty acids in attached lipid.