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目的 研究促甲状腺素释放激素 (thyrotropin releasinghormone ,TRH)与高渗氯化钠 醋酸钠 右旋糖酐 40 (hy pertonicsodiumacetate /dextran 40 ,HSAD)伍用对急进高原失血性休克合并肺水肿大鼠的治疗作用。方法 实验在海拔3 760m的西藏拉萨市进行 ,急进高原大鼠 49只 ,从股动脉放血至 5 0mmHg ,静脉注射 5 μl/kg油酸制造肺水肿 ,维持该血压 1h ,复制失血性休克合并肺水肿模型。实验分为正常对照组 (不放血、不给油酸 )、单纯休克组、失血性休克合并肺水肿对照组、乳酸林格 ( 4ml/kg ,LR)对照组、TRH( 5mg/kg)组 ,HSAD( 4ml/kg)单用组和TRH与HSAD合用组 ,每组 7只动物。观察给药后 15、3 0、60、12 0min的血流动力学指标变化 ,3 0min和 12 0min的血气指标变化和 12 0min肺脑含水量变化。结果 TRH( 5mg/kg)与HSAD( 4ml/kg)单用或伍用 ,给药后MAP升高 ,LVSP、±dp/dtmax改善 ,酸碱平衡紊乱减轻 ,肺湿干质量比减少 ,其中两药伍用疗效在众多方面都比单独给药为强。结论 TRH与HSAD单用及伍用对高原失血性休克合并肺水肿大鼠有良好的抗休克及减轻肺水肿的作用 ,其中两药伍用疗效更优
Objective To investigate the therapeutic effect of combination of thyrotropin releasing hormone (TRH) and hypertonic sodium chloride sodium dextran 40 (HSAD) on acute hemorrhagic shock and pulmonary edema in rats. Methods The experiment was carried out in Lhasa, Tibet at an altitude of 3 760 m. 49 rats were rapidly ascended to the plateau to bleed from the femoral artery to 50 mmHg and injected with 5 μl / kg oleic acid intravenously to maintain the blood pressure for 1 hour. Edema model. The experiment was divided into normal control group (no bleeding, no oleic acid), simple shock group, hemorrhagic shock combined pulmonary edema control group, lactated Ringer’s (4ml / kg, LR) HSAD (4ml / kg) alone and TRH combined with HSAD, seven animals per group. The changes of hemodynamics at 15, 30, 60 and 120 min, the changes of blood gas at 30 min and 120 min and the changes of pulmonary water content at 120 min were observed. Results After treatment with TRH (5mg / kg) and HSAD (4ml / kg) alone or in combination, MAP increased, LVSP and ± dp / dtmax improved, the acid-base balance disorder decreased, The efficacy of the drug is superior to that of the drug alone in many aspects. Conclusion TRH and HSAD alone and in combination with high altitude hemorrhagic shock with pulmonary edema in rats have good anti-shock and reduce pulmonary edema, which two drugs with better efficacy