氯胺酮对感染性休克大鼠保护作用的研究

目的　观察氯胺酮对感染性休克大鼠血流动力学、血浆肿瘤坏死因子α( TNFα)和白细胞介素 6 ( IL 6 )水平的影响 ,探讨其可能的抗休克机制。方法　取健康成年雄性 ( SD)大鼠 2 0只 ,采用盲肠结扎加穿孔 ( CL P)法复制败血症或感染性休克模型。随机分为假 CL P组、CL P组、氯胺酮 组和氯胺酮 组。假CL P和 CL P组术前 30 m in经股静脉持续输注生理盐水 5 ml· kg- 1· h- 1 ,氯胺酮 和氯胺酮 组分别输注氯胺酮 5 m g· kg- 1· h- 1和 10 m g· kg- 1· h- 1。经股动脉穿刺置管 ,持续监测平均动脉压 ( MAP)、心率 ( HR)及采集血样 ,应用酶联免疫吸附试验 ( EL ISA)检测血浆 TNFα和 IL 6水平。结果　 CL P组术后 MAP进行性下降 ,HR则先加快后减慢 ;血浆 TNFα和 IL 6水平明显升高。两种剂量的氯胺酮处理均能逆转 MAP和 HR下降 ,同时抑制血浆 TNFα和 IL 6水平升高 ,尤以氯胺酮 组作用更加明显。结论　氯胺酮对败血症或感染性休克大鼠具有明显的保护效应 ,其机制可能主要是拮抗促炎性细胞因子的产生

Protective effect of ketamine against septic shock in rats

OBJECTIVE: To investigate the effects and the mechanism of ketamine on hemodynamics and pro-inflammatory cytokine levels of plasma in septic shock rats. METHODS: Cecal ligation and puncture (CLP) was used to reproduce septic shock model. Twenty healthy and male Sprague-Dawlay (SD) rats weighing (225+/-25) g were randomly divided into four equal groups: Sham CLP group, CLP group, ketamine I (KT I) and ketamine II (KT II) group. Thirty minutes before CLP, normal saline (0.9 %) was infused continuously at a rate of 5 ml.kg(-1).h(-1) through the left femoral vein cannula in sham CLP and CLP group, and ketamine (5 mg.kg(-1).h(-1) and 10 mg.kg(-1).h(-1), respectively) was infused continuously in KT I or KT II group. The right femoral artery was cannulated to monitor mean arterial pressure. The plasma levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured using enzyme-linked immunosorbent assays (ELISA). RESULTS: CLP produced progressive hypotension, and a large increase in the plasma TNF-alpha and IL-6 concentrations. The hemodynamic responses were reversed and the cytokine responses were suppressed in ketamine treated animals. CONCLUSION: Ketamine administration has protective effect against septic shock in CLP rats.