多器官功能不全综合征动物模型的建立及其血流动力学变化

目的 探讨建立多器官功能不全综合征（MODS）动物模型并观察其血流动力学变化的可能性。方法标准大肠杆菌缓慢注入16只雄性健康小香猪的右侧颈内静脉，注入前及注入后1h、3h、5h、7h用Swan—Ganz氏漂浮导管检测其血流动力学指标：心输出量（CO），心脏每搏输出量指数（SVI），左室每搏功指数（LVSWI），肺毛细血管楔压（PAWP），心脏指数（CI），体循环阻力指数（SVRI），记录其平均动脉压（MAP）。结果注入大肠杆菌后，这些血流动力学指标的变化可分3期。注入大肠杆菌即刻至1h进入低排高阻期，MAP、CI、SVI和LVSWI均显著低于制模前，而SVRI显著高于制模前（均P〈0．05）。注入大肠杆菌后3—5h为高排低阻期，MAP、SVRI降低；CI略升高，但与制模前无显著性差异。7h后为低排低阻期，MAP、CI、SVRI、LVSWI均进行性降低（均P〈0．05）。注入大肠杆菌1h后动物模型PAWP一直显著高于制模前水平（均P〈0．05）。结论建立了标准的MODS动物模型，可用漂浮导管系统观察MODS发病过程中各个时期的血流动力学变化，以为MODS的临床研究提供实验基础。

Establishment of animal model of multiple organ dysfunction syndrome and the hemodynamic changes thereof

Objective To investigate the feasibility to establish the animal model of multiple organ dysfunction syndrome （MODS） and to observe the hemodynamic changes thereof. Methods Culture of Escherichia coli was injected into 16 one-year-old male swine. Swan-Ganz floating catheter was inserted into the right jugular vein to measure the following hemodynamic parameters： mean arterial pressure （MAP）, cardiac output （CI）, systemic vascular resistance index （SVRI）, left ventricular stroke woke index （LVSWI）, pulmonary artery wedge pressure （PAWP） 1 b, 3 h, 5 h, and 7 h after injection. Results The dynamic changes after the injection of E. coli could be divided into 3 stages. The MAP, CI, SVI, and LVSWI immediately to 1 h after the injection of E. coli （low resistance and high output stager） were significantly lower, and the SVRI significantly higher than those before the model establishment （all P〈0.05）. In the high resistance and high output stage （3 h-5 h after the model establishment） the MAP and SVRI were significantly decreased, and the CI slightly increased, however, not significantly. In the low resistance and low output stage （7 h after the model establishment） the MAP, CI, SVRI, and LVSWI all progressively decreased （all P〈0.05）. Since 1 hour after the injection of E. coli the PAWP remained significantly higher than that before the model establishment （all P〈0.05）. Conclusion A standard MODE animal model has been established. Floating catheter can be used to observe the hemodynamic changes so as to provide experimental basis for clinical research of MODS.