复方高渗盐溶液对大鼠低血容量性休克心肌细胞膜泵功能的影响

目的 探讨低血容量性休克大鼠心肌细胞膜泵功能的变化及高渗盐溶液对其泵功能的影响。方法 成年Wistar大鼠96只，随机分成高渗盐溶液组（HSH组）和生理盐水组（NS组），每组48只。双阶段放血法制备大鼠休克模型，按休克不同时相分为休克前、休克及复苏后30、60、90、120min6个时相，分别测定心肌细胞膜ATP酶活性并行心肌细胞超微结构观察。结果 HSH组中休克时的心肌细胞膜ATP酶活性明显低于休克前及复苏后90、120min（P〈0．05），而NS组休克时和复苏后各时间点心肌细胞膜ATP酶活性均明显低于休克前（P〈0．05）。HSH组复苏后各时间点心肌细胞膜ATP酶活性均明显高于NS组（P〈0．01）。结论 低血容量性休克可导致心肌细胞膜ATP酶活性降低，能量消耗增加，细胞膜离子泵功能衰竭；复方高渗盐液不但能快速改善休克引起的血容量不足，而且能恢复心肌细胞膜离子泵功能。

Effects of compound hyperosmotic solution on ionic pump functions of cardiomyocyte cell membrane of rat after resuscitation from hemorrhagic shock

Objective To explore the changes in ionic pump functions of cardiomyocyte cell membrane and the effects of compound hyperosmotic saline solution. Method Ninety-six Wistar rats were randomized into two groups: hyperosmotic saline solution (HES, n=48) and 0.9% sodium chloride solution injection (NS, n=48). Hemorrhagic shock model was reproduced by a gradient volume-control phase exsanguination, combined with an adjustment phase, from femoral artery, with mean arterial pressure kept at 40kPa. At each time-point (pre-shock stage, shock, and 30min, 60min, 90min, 120min post-resuscitation), eight rats were used for various tests. The ATPase activity of cardiomyocyte cell membrane and the myocardial pathologic changes were investigated at different time points. Results Compared with shock stage, the ATPase activity of group HSH was significantly different (P<0.05) at pre-shock and post-resuscitation 90min, and 120min; In group NS, the ATPase activity at shock and post-resuscitation was lower than that of pre-shock (P<0.05). The ATPase activity of group HSH at post-resuscitation was higher than that of group NS (P<0.01). Conclusions Hypovolemic shock can decrease the ATPase activity of cardiomyocyte cell membrane, increase the use of energy, leading to inhibition of ionic pump functions. HSH can restore the activities of ionic pump functions.