纳洛酮对重症不可逆性失血性休克微循环的影响

用大鼠复制了重症不可逆性失血性休克的动物模型。建立了双摄象机同步录相法来观察血压和提肌微循环变化的关系。结果证明,在休克时,白细胞嵌塞毛细血管可能是输血治疗后微微循环不易恢复的原因之一。单纯给纳洛酮或单纯输血治疗效果均不理想。纳洛酮配合输血可以明显提高血压和脉压,脉动血流冲击停滞的血细胞,使微循环改善,血压和血流速度稳定,动物存活率明显提高。文章讨论了作用的机理,提出心脏因素和微循环因素互相影响,在重症不可逆性失血性休克发生中可能起重要作用。

The effect of naloxone on changes of microcirculation durinp irreversible hemorrhage shock

Thirty-six male Sprague-Dawley rats were used and divided into 3 groups ( n = 12) : simple hemorrhagic shock group, saline-treated group, and naloxone-treated group. A new method of synchronous video tape recording with 2 cameras was established to observe the relationship between the change of blood pressure and that of microcirculation of cremaster muscle.It has been shown that the plugging of WBC in capillaries may be the reason for no reflow in microvesseis after transfusion anc infusion during irreversible shock state. Administration of naloxone followed by rein-fusion of the shed blood increased blood pressure and pulse pressure. With the increase of pulse pressure, a pulsed blood flow rushed the ceased blood cells in capillaries, which eventually pushed them away and led to reperfusion of capillaries. This made blood pressure and velocity of blood flow increase stably. The 24 hou survival rate was significantly increased in naloxone-treated group(l0/12),as comparec with that in saline-treated group ( 1/12 ) . The mechanism of naloxone treatmen was discussed. It was suggested that the effects of cardiac event and microcirculatory event may influence each other, which plays an important role in the pathogenesis of irreversible hemorrhagic shock.