早期应用血管加压素对非控制出血性休克大鼠器官血流灌注及功能的影响

目的观察早期应用精氨酸血管加压素(arginine vasopressin,AVP)维持血压对非控制出血性休克大鼠器官血流灌注和功能的影响。方法 96只SD大鼠分为对照组(低压复苏)和AVP组(AVP 5×10-4 U·m L-1)。制备非控制出血性休克模型,观察早期(模拟院前救治阶段)应用AVP维持血压(50 mm Hg,3 h)对休克动物的心功能指标和组织氧供/氧耗、肝/肾血流量、肝/肾功能及其线粒体功能的影响。结果早期应用AVP维持血压可明显改善心功能指标,提高心输出量和增加组织氧供/氧耗;同时AVP治疗也明显提高了肝血流量、改善肝线粒体功能,并明显降低了休克后升高的肝功能指标AST和ALT,其效果明显优于对照组。但AVP组的肾血流量低于对照组,且2组间肾线粒体功能和肾功能指标(BUN和Scr)差异无统计学意义。结论早期应用AVP可更有效的改善心功能、改善重要器官的血流灌注和肝线粒体功能,发挥抗休克作用。但AVP对肾功能的影响需进一步研究。

Effects of Early Administration of Arginine Vasopressin on Blood Perfusion and Organ Function of Uncontrolled Hemorrhagic Shock Rats

OBJECTIVE To investigate the effects of early administration of arginine vasopressin(AVP) on blood perfusion and organ function of uncontrolled hemorrhagic shock rats. METHODS Ninety-six SD rats were divided into AVP group (5×10^-4 U·mL^-1 AVP with hypotensive resuscitation) and control group(hypotensive resuscitation). Uncontrolled hemorrhagic shock model was adopted, the effects of early administration (to mimic the pre-hospital treatment period) of AVP to maintain the blood pressure (50 mmHg, 3 h) on cardiac function, blood perfusion, vital organ and mitochondrial function were observed. RESULTS Early application of AVP significantly improved the cardiac function, increased cardiac output and oxygen delivery and oxygen utilization, improved hepatic blood flow, protected the hepatic function and its mitochondrial function in shock rats, as compared with hypotensive resuscitation alone. But the renal blood flow in AVP group was lower than that in control group, and the renal function and its mitochondrial function were not different between the two groups. CONCLUSION Early AVP therapys effectively improves cardiac function, increases tissue blood flow and protects hepatic mitochondrial function, final plays the anti-shock effects. But the role of AVP on renal function following shock needs further elucidation.