丙酮酸乙酯对脓毒症休克犬血流动力学的影响
感染性休克；丙酮酸乙酯；血流动力学；抗炎试剂,,感染性休克；丙酮酸乙酯；血流动力学；抗炎试剂,关键词：感染性休克；丙酮酸乙酯；血流动力学；抗炎试剂,材料与方法,结果,讨论,参考文献：
摘要： 目的 探讨丙酮酸乙酯(EP)对脓毒症休克犬血流动力学的影响。方法 用内毒素(LPS)静脉注射复制犬脓毒症休克模型，8只犬随机分为对照组(n=3)和EP组(n=5)。对照组只接受林格氏液复苏。EP组除接受林格氏液复苏外，给予丙酮酸乙酯首剂0.05g/kg ，然后0.05g/(kg·h)持续泵入。脓毒症休克模型稳定后记为0小时，此后每小时收集血流动力学指标，共观察12小时。结果 EP组血压在8小时有明显回升(P<0.05)，两组比较有明显差异(P<0.05)。两组的CI均有上升(P<0.05)，EP组表现更加明显，但两组未能有显著差异(P>0.05)。两组的CVP均有上升(P<0.05)，6小时后EP组有所回落，两组比较有明显差异(P<0.05)。两组的MPAP均明显上升(P<0.05)， EP组逐渐降至基线水平，对照组无此趋势(P<0.05)。休克模型成功后，SVI、LVSW明显下降，两组均迅速回复到基线水平，两组差异不明显(P>0.05)。休克模型成功后，两组RVSWI均升高，EP组8小时降至基线水平，两组比较有明显差异(P<0.05)。休克后两组SVRI均明显下降(P<0.05)， EP组逐渐上升，8小时后两组比较有明显差异(P<0.05)。两组PVRI均明显上升(P<0.05)， EP组逐渐回落，8小时后两组比较有明显差异(P<0.05)。结论 丙酮酸乙酯可以改善脓毒症休克犬血流动力学。关键词：感染性休克；丙酮酸乙酯；血流动力学；抗炎试剂
Effect of ethyl pyruvate on systemic hemodynamics in dogs with septic shock
KOU Qiuye,GUANG Xiangdong
(SICU,The First Affiliated Hospital of Sun Yatsen University,Guangzhou 510080，China)
Abstract: Objective To investigate the systemic hemodynamic effects of treatment with ethyl pyruvate(EP) in dogs with septic shock.Methods Eight dogs with septic shock induced by lipopolysaccharides(LPS) were randomly divided into two groups.Dog randomly received placebo(Ringer's solution;control group,n=3) or EP in lactated Ringer's solution (n=5 ;0.05 g/kg loading dose over 10 mins,thereafter 0.05 g/kg/hr for 12 hrs).Parameters of hemodynamics were monitored at every hour after basic measurements(preLPS).Results After LPS infusion,mean arterial pressure(MAP) dropped significantly,but elevated and maintained at the baseline level in dogs treated with EP.Such tendency did not happen in the control group(P<0.05).Although there was no statistically significant intergroup difference(P>0.05),EP infusion increased cardiac output to greater than the control group.CVP,MPAP,RVSWI decreased to lower levels in the EP group(P<0.05),despite comparable fluid administration.SVI、LVSWI initially reduced markedly,and increased towards baseline level quickly,there was no difference between the two group(P>0.05).SVRI reduced in both group,but EP group increased gradually to higher level compared with control group(P<0.05).On the contrary,pulmonary vascular resistance index(PVRI) elevated initially,and decreased to baseline level in EP group,whereas remained at the higher level in control animals(P<0.05) .Conclusion Ethyl pyruvate infusion resulted in improved hemodynamic stability in dogs with septic shock. ......
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