论文部分内容阅读
目的:研究应用聚偏氟乙烯(polyvinylidene difluoride,PVDF)-丝氨酸(serine,Ser)吸附膜血液灌流对感染性休克氧代谢的影响。方法:雄性家猪16头,给予内毒素(lipopolysaccharides,LPS)1μg.kg-.1h-1静脉泵入4 h复制感染性休克模型。随机分为实验组(E组),应用PVDF-Ser吸附膜进行血液灌流2 h;对照组(C组),应用空白灌流器进行血液灌流2 h。于基础期、注射内毒素后和血液灌流后分别测定中心静脉血氧饱和度(central venous oxygen saturation,ScvO2)、氧输送(oxygen delivery,DO2)、氧消耗(oxygenconsumption,VO2)、氧摄取率(oxygen extraction ratio,O2ER)、血乳酸(lactation,LACT)和胃粘膜内pH(intramucosal pH,pHi)。结果:血液灌流后E组ScvO2明显高于C组(68±1.7%vs 62±3.1%,P=0.006);VO2、O2ER和LACT显著低于C组,分别为(204±28.1 mL.min-1.m-2vs 249±30.7 mL.min-1.m-2,p=0.017)、(33±3.3%vs 39±5.0%,P=0.031)和(3.1±1.0 mmol/L vs 5.4±1.7mmol/L,P=0.022);E组的pHi较C组显著改善(7.29±0.09 vs 7.22±0.06,P=0.004)。结论:应用PVDF-Ser吸附膜进行血液灌流,可以有效减少感染性休克的氧耗、纠正组织氧债和低灌注,改善机体氧代谢异常。
Objective: To study the effect of polyvinylidene difluoride (PVDF) -serine (Ser) adsorption membrane hemoperfusion on the oxygen metabolism in septic shock. Methods: Sixteen male domestic pigs were given intravenous injection of 1μg.kg-1h-1 lipopolysaccharides (LPS) for 4 hours to replicate septic shock model. The rabbits were randomly divided into experimental group (group E), PVDF-Ser adsorbed membrane for 2 h, control group (group C), and blank perfusion for 2 h. Central venous oxygen saturation (ScvO2), oxygen delivery (DO2), oxygen consumption (VO2) and oxygen uptake rate were measured in the basal phase, endotoxin injection and after perfusion. oxygen extraction ratio, O2ER, lactation (LACT) and intramucosal pH (pHi). Results: After hemoperfusion, ScvO2 in group E was significantly higher than that in group C (68 ± 1.7% vs 62 ± 3.1%, P = 0.006); VO2, O2ER and LACT were significantly lower than those in group C (204 ± 28.1 mL.min- (33 ± 3.3% vs 39 ± 5.0%, P = 0.031) and (3.1 ± 1.0 mmol / L vs 5.4 ± 1.7 vs. 1.69 ± 30.7 mL.min-1.m-2, p = 0.017) mmol / L, P = 0.022). The pHi in group E was significantly improved compared with group C (7.29 ± 0.09 vs 7.22 ± 0.06, P = 0.004). Conclusion: The application of PVDF-Ser adsorbed membrane for hemoperfusion can effectively reduce the oxygen consumption of septic shock, correct the tissue oxygen debt and hypoperfusion and improve the body’s oxygen metabolism abnormality.